# BARIUM SPRINGS HOME FOR CHILDREN

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

## Provider details

- **NPI number:** 1598048225
- **Authorized official:** CELESTE INEZ DOMINGUEZ (CEO)
- **Authorized official phone:** (704) 873-2211

## Contact information

- **Practice address:** 153 BARIUM SPRINGS DRIVE, STATESVILLE, NC 28677
- **Practice address phone:** (704) 873-1011
- **Practice address fax:** (704) 832-2253
- **Mailing address:** 507 COURTHOUSE DR, WILKESBORO, NC 28697-2926
- **Mailing address phone:** (336) 667-3333
- **Mailing address fax:** (336) 667-8749

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 323P00000X | Psychiatric Residential Treatment Facility | MHL-049-087 | NC | Yes |

## Other

- **Enumeration date:** 09/20/2011
- **Last updated:** 07/03/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3404582 | — | NC |
| 01 | — | MHL-049-087 | DHSR | NC |
