Organization
SMOKY MOUNTAIN CENTER FOR MH/DD/SAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN D INGRAHAM MA (CHIEF EXECUTIVE OFFICER)
(828) 586-5501
Entity
Organization
Contact information
Practice address
44 BONNIE LN, SYLVA, NC 28779-8511
(828) 586-5501
(828) 586-3965
Mailing address
44 BONNIE LN, SYLVA, NC 28779-8511
(828) 586-5501
(828) 586-3965
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6703003
—
NC
Enumeration date
02/13/2013
Last updated
02/22/2013
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