Provider Demographics
NPI:1477683720
Name:ADULT CENTER FOR ENRICHMENT, INC.
Entity Type:Organization
Organization Name:ADULT CENTER FOR ENRICHMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALVA
Authorized Official - Middle Name:S
Authorized Official - Last Name:CROMARTIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-274-3559
Mailing Address - Street 1:PO BOX 13048
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27415-3048
Mailing Address - Country:US
Mailing Address - Phone:336-274-3559
Mailing Address - Fax:336-373-0926
Practice Address - Street 1:11 OAK BRANCH DR
Practice Address - Street 2:SUITE B
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-2453
Practice Address - Country:US
Practice Address - Phone:336-274-3559
Practice Address - Fax:336-373-0926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408282Medicaid