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CHANGING PHASES BEHAVIORAL SUPPORT ONE
NPI 1811057045
Residential Treatment Facility, Emotionally Disturbed Children in Greensboro, NC

Active since December 11, 2006
1609 CLEMMONS ST, GREENSBORO, NC 27406(336) 333-2542(336) 333-2858 Get Directions Write a Review

NPPES record last updated: March 12, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Changing Phases Behavioral Support One NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHANGING PHASES BEHAVIORAL SUPPORT ONE (NPI 1811057045) is a healthcare organization registered as a residential treatment facility, emotionally disturbed children in Greensboro, North Carolina and active in the NPI registry since December 2006. The organization lists Quinten Cullins, Program Director, as its authorized official.

NPPES Registry Identity

NPI1811057045
Entity TypeOrganization
Primary Taxonomy322D00000X
Legal Business NameCHANGING PHASES BEHAVIORAL SUPPORT
Location Address1609 CLEMMONS STGreensboro, NC 27406-2870
Mailing Address338 N Elm St, Suite 215Greensboro, NC 27401-2177 · (336) 333-2542 · Fax (336) 333-2858
Phone(336) 333-2542
Fax(336) 333-2858
Organization SubpartNo
Authorized OfficialQuinten CullinsProgram Director · (336) 333-2542
Enumeration DateDecember 11, 2006
Last NPPES UpdateMarch 12, 2012
✔ NPI 1811057045 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyResidential Treatment Facility, Emotionally Disturbed ChildrenResidential Treatment Facilities
Taxonomy Code322D00000X
Licenses✔ Licensed in NC · MHL-041-794✔ Licensed in NC · MHL-041-894
Definition
A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X
1609 CLEMMONS ST, Greensboro, NC 27406
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Other Names 1

Doing Business AsChanging Phases Behavioral Support One

Other Identifiers 4

Medicaid6006908NC
Medicaid6604413NC
Medicaid8301765GNC
Medicaid8301765NC

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Changing Phases Behavioral Support's NPI number?

The NPI number for Changing Phases Behavioral Support is 1811057045. It was assigned to this organization in the NPPES registry on December 11, 2006. The provider is doing business as Changing Phases Behavioral Support One.

Where is Changing Phases Behavioral Support located?

Changing Phases Behavioral Support is located at 1609 Clemmons St, Greensboro, NC 27406. The listed phone number is (336) 333-2542.

What is Changing Phases Behavioral Support's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Emotionally Disturbed Children with taxonomy code 322D00000X.

When was this NPI record last updated?

The NPPES record for Changing Phases Behavioral Support was last updated on March 12, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.