1477683720 NPI number — ADULT CENTER FOR ENRICHMENT, INC.

Table of content: ILENE CLAPPER (NPI 1447067244)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477683720 NPI number — ADULT CENTER FOR ENRICHMENT, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADULT CENTER FOR ENRICHMENT, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477683720
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/01/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5603 NEW GARDEN VILLAGE DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENSBORO
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27410
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
336-545-5352
Provider Business Mailing Address Fax Number:
336-886-4102

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2701 HENRY STREET
Provider Second Line Business Practice Location Address:
2701 HENRY STREET
Provider Business Practice Location Address City Name:
GREENSBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27405
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-545-5352
Provider Business Practice Location Address Fax Number:
336-886-4102
Provider Enumeration Date:
03/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
TUTTEROW
Authorized Official First Name:
KENNETH
Authorized Official Middle Name:
ALLAN
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
336-545-5418

Provider Taxonomy Codes

  • Taxonomy code: 261QA0600X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3408282 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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