# TL BEARWALLOW LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Lodge at Bearwallow
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225894470
- **Authorized official:** BRETT MCGENNIS (COO)
- **Authorized official phone:** (412) 742-7546

## Contact information

- **Practice address:** 42 HEROS WAY, HENDERSONVILLE, NC 28792
- **Practice address phone:** (877) 279-8972
- **Mailing address:** 41 HEROS WAY, HENDERSONVILLE, NC 28792-0145

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 103TC1900X | Counseling Psychologist | — | NULL | — |
| 103TC1900X | Counseling Psychologist | — | — | — |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 02/26/2024
- **Last updated:** 02/26/2024