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Organization
UNIVERSAL MHDDSAS
Active
Organization
UNIVERSAL MHDDSAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BROOK PHILLIPS (DIRECTOR OF OPERATIONS)
(828) 759-4064
Entity
Organization
Contact information
Practice address
10 N MAIN ST, BURNSVILLE, NC 28714-2925
(828) 682-1551
Mailing address
839 WILKESBORO BLVD NE, LENOIR, NC 28645-4612
(828) 759-2228
(828) 759-0159
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5950147
—
NC
05
—
6006103
—
NC
05
—
8300624B
—
NC
05
—
8300624G
—
NC
05
—
8300624K
—
NC
Enumeration date
02/13/2007
Last updated
10/15/2010
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