1821113267 NPI number — CATAWBA RIVER BEHAVOIRAL & TREATMENT ASSOCIATES, INC.

Table of content: (NPI 1821113267)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821113267 NPI number — CATAWBA RIVER BEHAVOIRAL & TREATMENT ASSOCIATES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CATAWBA RIVER BEHAVOIRAL & 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:
1821113267
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/15/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
501 E UNION ST
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:
28655-3455
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:
4580 SNOWHILL CHURCH RD
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:
28655-6228
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:
03/21/2007

Additional Information

Authorized Official

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

Provider Taxonomy Codes

  • Taxonomy code: 322D00000X , 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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