Provider Demographics
NPI:1518292036
Name:WINDSOR PSYCHOSOCIAL REHABILITATION, INC.
Entity Type:Organization
Organization Name:WINDSOR PSYCHOSOCIAL REHABILITATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:FAYE
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-794-1500
Mailing Address - Street 1:PO BOX 725
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:NC
Mailing Address - Zip Code:27983-0725
Mailing Address - Country:US
Mailing Address - Phone:252-794-1500
Mailing Address - Fax:252-794-1501
Practice Address - Street 1:117 E GRANVILLE ST
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:NC
Practice Address - Zip Code:27983-6753
Practice Address - Country:US
Practice Address - Phone:252-794-1500
Practice Address - Fax:252-794-1501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-16
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health