| H. Diane Jenkins, Llc | |
|
110 W Elm St Yadkinville NC 27055-3313 | |
| (336) 575-3747 | |
| (866) 413-4793 |
| Full Name | H. Diane Jenkins, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 110 W Elm St, Yadkinville, North Carolina |
| Authorized Official Name and Position | Harriet Diane Jenkins (CEO) |
| Authorized Official Contact | 3365753747 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| H. Diane Jenkins, Llc 2820 Northbridge Rd Winston Salem NC 27103-6517 Ph: (336) 575-3747 | H. Diane Jenkins, Llc 110 W Elm St Yadkinville NC 27055-3313 Ph: (336) 575-3747 |
| NPI Number | 1891989752 |
|---|---|
| Provider Enumeration Date | 09/04/2007 |
| Last Update Date | 10/05/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891989752 | NPI | - | NPPES |
| 6003126 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | C002645 (North Carolina) | Primary |
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