CLASSIQUE RESIDENTIAL SERVICES-LLC (NPI# 1396924221) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396924221 |
| Entity Type | Organization |
| Organization Name | CLASSIQUE RESIDENTIAL SERVICES-LLC |
| Practice Address |
340 Burlingate Dr Apt E Greensboro NC 27407-1295 |
| Practice Telephone | 3365106966 |
| Mailing Telephone | 3365106966 |
| Enumeration Date | 2007-10-27 |
| Last Update Date | 2007-10-27 |
| Authorized Official Name | MR. HENRY AUGUSTUS LUTTERODT (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3365106966 |
| Authorized Official Credential | MS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities | ||
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | NC | Residential Treatment Facilities |
| Street Address |
340 BURLINGATE DR APT E |
| City | GREENSBORO |
| State | NC |
| Zip Code | 27407-1295 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093326019 | Marie Louise Phillips | Behavior Technician | 111 Domona Dr, Unit 6, Greensboro, NC 27407 | 2020-08-13 |
| 1306472709 | Blondine Yvonne Wynn | Home Health Aide | 2812 Apt 2g Vanstory Street, Greesboro, NC 27407 | 2020-03-17 |
| 1104452994 | Monyetta Marie Howell | Counselor | 2216 W. Meadowview Road, Wilmington Bldg. Suite 207, Greensboro, NC 27407 | 2020-03-12 |
| 1215456769 | Tiffany R. Wright | Massage Therapist | 317 H South Westgate Drive, Greensboro, NC 27407 | 2017-09-15 |
| 1992225676 | Kendra Edwards | Social Worker | 1 Centerview Dr Ste 103, Greensboro, NC 27407 | 2017-06-22 |
| 1477902674 | Triad Integrative Wellness Center Inc | Acupuncturist | 315j South Westgate Dr, Greensboro, NC 27407 | 2016-06-08 |
| 1083098354 | Kathryn Theall | Counselor | 1901 Adams Farm Pkwy, Greensboro, NC 27407 | 2015-07-16 |
| 1962886333 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 5710-w West Gate City Blvd, Greensboro, NC 27407 | 2015-07-16 |
| 1619356177 | Lindsey King | Registered Nurse | 302 Pomona Drive, Greensboro, NC 27407 | 2015-05-29 |
| 1255737664 | M.a.p.p.s. | Clinic/Center | 2216 West Meadowview Road Ste 204, Greensboro, NC 27407 | 2014-11-12 |
| Find all providers in zip 27407 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710489976 | Moravian Enterprises, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 122 North Elm St., Suite 810, Greensboro, NC 27401 | 2018-03-05 |
| 1922555671 | United Living, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3200 Bernard St, Greensboro, NC 27405-3724 | 2016-09-09 |
| 1134599590 | Moravian Family Care Home | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2905 Holmes Rd, Greensboro, NC 27405-4621 | 2015-09-29 |
| 1407230469 | United Living, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4449 Burlington Rd, Lot 29, Greensboro, NC 27405-8683 | 2015-07-18 |
| 1982087458 | United Living, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3908 Bluestem Dr, Greensboro, NC 27405-8251 | 2015-07-02 |
| 1649684374 | United Living, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 181 Big Oak Trail, Greensboro, NC 27214 | 2014-06-20 |
| 1831503523 | United Living, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 609 Herman Gist Rd, Greensboro, NC 27401-4799 | 2014-06-20 |
| 1336571603 | Wescare Professional Services, LLC. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1311 Gorrell St, Greensboro, NC 27401-3507 | 2013-08-08 |
| 1962840900 | Wescare Professional Services, LLC. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1309 Gorrell St, Greensboro, NC 27401-3507 | 2013-06-12 |
| 1497193403 | Wescare Professional Services, LLC. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2204 Oakmont Ct, Greensboro, NC 27407-6076 | 2013-06-12 |
| Find all providers in GREENSBORO | ||||
| City | GREENSBORO |
| Zip Code | 27407 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.