1821115221 NPI number — BARIUM SPRINGS HOME FOR CHILDREN

Table of content: (NPI 1821115221)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821115221 NPI number — BARIUM SPRINGS HOME FOR CHILDREN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BARIUM SPRINGS HOME FOR CHILDREN
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:
CHILDREN'S HOPE ALLIANCE
Provider Other Organization Name Type Code:
3
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:
1821115221
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/08/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
194 BARIUM SPRINGS DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STATESVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28677-8453
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-832-2200
Provider Business Mailing Address Fax Number:
704-838-1541

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
209 BARIUM SPRINGS DRIVE
Provider Second Line Business Practice Location Address:
MULTI SPECIALTY GROUP
Provider Business Practice Location Address City Name:
STATESVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28677
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-873-1011
Provider Business Practice Location Address Fax Number:
704-924-7683
Provider Enumeration Date:
03/23/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DOMINGUEZ
Authorized Official First Name:
CELESTE
Authorized Official Middle Name:
INEZ
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
704-832-2211

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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