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Organization

BARIUM SPRINGS HOME FOR CHILDREN

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CELESTE INEZ DOMINGUEZ (CEO)
(704) 873-2211
Entity
Organization

Contact information

Practice address
138 BARIUM SPRINGS DRIVE, KING - PRTF, STATESVILLE, NC 28677
(704) 873-1011
(704) 924-7683
Mailing address
PO BOX 1, BARIUM SPRINGS, NC 28010-0001
(704) 873-1011
(704) 832-2253

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
323P00000X
Psychiatric Residential Treatment Facility
Primary
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3404554
NC
Enumeration date
05/30/2007
Last updated
07/11/2018
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