Provider First Line Business Practice Location Address:
3736 OLD VINEYARD RD
Provider Second Line Business Practice Location Address:
OLD VINEYARD BEHAVIORAL HEALTH SERVICES
Provider Business Practice Location Address City Name:
WINSTON SALEM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27284
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-794-3556
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/05/2009