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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
153 BARIUM SPRINGS DRIVE, STATESVILLE, NC 28677
(704) 873-1011
(704) 832-2253
Mailing address
507 COURTHOUSE DR, WILKESBORO, NC 28697-2926
(336) 667-3333
(336) 667-8749

Taxonomy

Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
MHL-049-087
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3404582
NC
01
MHL-049-087
DHSR
NC
Enumeration date
09/20/2011
Last updated
07/03/2018
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