# BARIUM SPRINGS HOME FOR CHILDREN KULYNYCH COTTAGE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033428487
- **Authorized official:** MR. JOHN KOPPELMEYER MSW (PRESIDENT/CEO)
- **Authorized official phone:** (704) 872-4157

## Contact information

- **Practice address:** 517 BOSTON AVENUE, WILKESBORO, NC 28659
- **Practice address phone:** (336) 667-5095
- **Practice address fax:** (336) 927-6541
- **Mailing address:** PO BOX 1, BARIUM SPRINGS, NC 28010-0001
- **Mailing address phone:** (704) 872-4157
- **Mailing address fax:** (704) 924-7683

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | NOT YET ASSIGNED | NC | Yes |

## Other

- **Enumeration date:** 10/04/2010
- **Last updated:** 10/04/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | NOT YET ASSIGNED | — | NC |