Basic Information
| Provider Information | |||||||||
| NPI: | 1114093218 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COMPANIONS ON THE JOURNEY, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2640 WILLARD DAIRY RD | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | HIGH POINT | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272658708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3368691405 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2640 WILLARD DAIRY RD | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | HIGH POINT | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272658708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3368691405 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/28/2006 | ||||||||
| LastUpdateDate: | 07/02/2010 | ||||||||
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| AuthorizedOfficialLastName: | STURGIS | ||||||||
| AuthorizedOfficialFirstName: | LAURA | ||||||||
| AuthorizedOfficialMiddleName: | JERENE | ||||||||
| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 3368691405 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251C00000X | MHL-041-796 | NC | Y | Agencies | Day Training, Developmentally Disabled Services |
No ID Information.