1023147303 NPI number — CATAWBA RIVER BEHAVIORAL & TREATMENT ASSOCIATES, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023147303 NPI number — CATAWBA RIVER BEHAVIORAL & TREATMENT ASSOCIATES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CATAWBA RIVER BEHAVIORAL & TREATMENT ASSOCIATES, 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:
6
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:
1023147303
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/09/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1453
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MORGANTON
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28680-1453
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-437-7110
Provider Business Mailing Address Fax Number:
828-438-3809

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
124 NORMANDY DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MORGANTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28655-4126
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-437-7110
Provider Business Practice Location Address Fax Number:
828-438-3809
Provider Enumeration Date:
03/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BOSTIAN
Authorized Official First Name:
CAROL
Authorized Official Middle Name:
BARKER
Authorized Official Title or Position:
SECRETARY TREASURER
Authorized Official Telephone Number:
828-437-7110

Provider Taxonomy Codes

  • Taxonomy code: 322D00000X , with the licence number:  012090 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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