Organization
BARIUM SPRINGS HOME FOR CHILDREN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN KOPPELMEYER (PRESIDENT)
(704) 872-4157
Entity
Organization
Contact information
Practice address
153 BARIUM SPRINGS DRIVE, SULLIVAN HOME, STATESVILLE, NC 28677-6238
(704) 873-1011
(704) 832-2253
Mailing address
PO BOX 1, BARIUM SPRINGS, NC 28010-0001
(704) 873-1011
(704) 832-2253
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL049087
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603566
—
NC
Enumeration date
03/28/2007
Last updated
08/22/2009
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