# BARIUM SPRINGS HOME FOR CHILDREN

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

## Provider details

- **NPI number:** 1194844654
- **Authorized official:** MR. JOHN KOPPELMEYER (PRESIDENT)
- **Authorized official phone:** (704) 872-4157

## Contact information

- **Practice address:** 153 BARIUM SPRINGS DRIVE, SULLIVAN HOME, STATESVILLE, NC 28677-6238
- **Practice address phone:** (704) 873-1011
- **Practice address fax:** (704) 832-2253
- **Mailing address:** PO BOX 1, BARIUM SPRINGS, NC 28010-0001
- **Mailing address phone:** (704) 873-1011
- **Mailing address fax:** (704) 832-2253

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | MHL049087 | NC | Yes |

## Other

- **Enumeration date:** 03/28/2007
- **Last updated:** 08/22/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 6603566 | — | NC |