Provider Demographics
NPI:1700192655
Name:THE OPEN DOOR PROGRAM
Entity Type:Organization
Organization Name:THE OPEN DOOR PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLAUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-285-8734
Mailing Address - Street 1:2301 W MEADOWVIEW RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-3723
Mailing Address - Country:US
Mailing Address - Phone:336-285-8734
Mailing Address - Fax:
Practice Address - Street 1:2301 W MEADOWVIEW RD
Practice Address - Street 2:SUITE 203
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-3723
Practice Address - Country:US
Practice Address - Phone:336-285-8734
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-28
Last Update Date:2010-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health