Provider Demographics
NPI:1265741904
Name:A PLUS WILLIAMSON CARE NETWORK, LLC
Entity type:Organization
Organization Name:A PLUS WILLIAMSON CARE NETWORK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:MONACA
Authorized Official - Middle Name:MAYE
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:BS QDDP
Authorized Official - Phone:336-558-3749
Mailing Address - Street 1:415 N EDGEWORTH ST STE 209
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-2071
Mailing Address - Country:US
Mailing Address - Phone:336-274-4140
Mailing Address - Fax:
Practice Address - Street 1:415 N EDGEWORTH ST STE 209
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-2071
Practice Address - Country:US
Practice Address - Phone:336-558-3749
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-29
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty