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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
397 3RD AVE SW, TAYLORSVILLE, NC 28681-4180
(828) 632-7005
(828) 632-0435
Mailing address
839 WILKESBORO BLVD NE, LENOIR, NC 28645-4612
(828) 759-2228
(828) 759-0159
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5900301
—
NC
05
—
6005060
—
NC
05
—
8300457B
—
NC
05
—
8300457G
—
NC
Enumeration date
02/13/2007
Last updated
08/22/2020
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