Organization
BEATITUDE HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW H BRADLEY IV MSW (PRESIDENT)
(828) 926-5591
Entity
Organization
Contact information
Practice address
470 TWIN BROOK DR, WAYNESVILLE, NC 28785-8348
(828) 926-5591
Mailing address
470 TWIN BROOK DR, WAYNESVILLE, NC 28785-8348
(828) 926-5591
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
996
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
136YF
BCBS OF NC
NC
05
—
6105027
—
NC
Enumeration date
11/02/2006
Last updated
12/06/2011
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