Provider Demographics
NPI:1396068508
Name:TREATMENT NETWORK, LLC
Entity type:Organization
Organization Name:TREATMENT NETWORK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-542-3190
Mailing Address - Street 1:308 POMONA DR STE A
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-1644
Mailing Address - Country:US
Mailing Address - Phone:336-542-3190
Mailing Address - Fax:336-855-0466
Practice Address - Street 1:308 POMONA DR STE A
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-1644
Practice Address - Country:US
Practice Address - Phone:336-542-3190
Practice Address - Fax:336-855-0466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-03
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8303143Medicaid