Provider Demographics
NPI:1700065604
Name:COMMUNITY NETWORK
Entity Type:Organization
Organization Name:COMMUNITY NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TARSHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-669-8181
Mailing Address - Street 1:6824 PEPPERDINE RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-9205
Mailing Address - Country:US
Mailing Address - Phone:336-669-8181
Mailing Address - Fax:336-887-5444
Practice Address - Street 1:6824 PEPPERDINE RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-9205
Practice Address - Country:US
Practice Address - Phone:336-669-8181
Practice Address - Fax:336-887-5444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-26
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health