Organization
TLC W
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA C BEESLEY (CEO)
(702) 292-2990
Entity
Organization
Contact information
Practice address
4480 S NC 16 HWY, MAIDEN, NC 28650-9030
(704) 951-8408
(704) 951-8407
Mailing address
4480 HWY 16 S, MAIDEN, NC 28650-9030
(828) 469-6098
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053859181
—
NC
Enumeration date
02/09/2017
Last updated
07/02/2019
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