OrganizationOutward Bound One, Llc(Outward Bound Community Services)Community Based Residential Treatment Facility, Mental Retardation and/or Developmental DisabilitiesResidential Treatment FacilitiesPractice Address620 Guilford College Rd, Ste G, Greensboro, NC 27409-2292(336) 553-9898PECOS EnrollmentBased on the most recent information from CMS, provider Outward Bound One, Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1164675815Provider TypeOrganizationFull NameOutward Bound One, LlcOther NameOutward Bound Community ServicesSubpartNoEnumeration Date10/28/2008Last Updated6/17/2016Contact InformationPractice LocationPractice Address620 Guilford College Rd, Ste G, Greensboro, NC 27409-2292Phone(336) 553-9898Fax(336) 447-1955Mailing LocationMailing Address620 Guilford College Rd, Ste G, Greensboro, NC 27409-2292Phone(336) 553-9898Fax(336) 447-1955Authorized OfficialNamePatrick, Trishonda (Executive Director)Phone(336) 553-9898Provider TaxonomiesCodeDescriptionLicenseCode320900000XPrimaryDescriptionCommunity Based Residential Treatment Facility, Mental Retardation and/or Developmental DisabilitiesResidential Treatment FacilitiesLicenseUnlisted IssuerCode251S00000XDescriptionCommunity/Behavioral HealthAgenciesLicenseUnlisted IssuerNorth CarolinaCode253Z00000XDescriptionIn Home Supportive CareAgenciesLicenseUnlisted Issuer