1124416235 NPI number — SOUNDVIEW FAMILY CARE HOMES INC

Table of content: CRYSTAL LYNN KEEFER LCSW (NPI 1902041775)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124416235 NPI number — SOUNDVIEW FAMILY CARE HOMES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUNDVIEW FAMILY CARE HOMES 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:
1124416235
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/26/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 272
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EAST FLAT ROCK
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28726-0272
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-694-1146
Provider Business Mailing Address Fax Number:
828-694-1146

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
30 SMITH GRAVEYARD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ASHEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28806-9655
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-694-1146
Provider Business Practice Location Address Fax Number:
828-694-1147
Provider Enumeration Date:
12/26/2014

Additional Information

Authorized Official

Authorized Official Last Name:
MUNIZ
Authorized Official First Name:
JUSTINA
Authorized Official Middle Name:
D
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
828-694-1146

Provider Taxonomy Codes

  • Taxonomy code: 310400000X , with the licence number:  FCL-011-348 , 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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