Organization
TIMBER RIDGE TREATMENT CENTER, INC.
Active
Organization
TIMBER RIDGE TREATMENT CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURIE DODGE HIBBERT MED. (V. PRESIDENT)
(704) 279-1199
Entity
Organization
Contact information
Practice address
665 TIMBER TRAIL, GOLD HILL, NC 28071
(704) 279-1199
(704) 279-7668
Mailing address
P O BOX 259, 665 TIMBER TRAIL, GOLD HILL, NC 28071-7661
(704) 279-1199
(704) 279-7668
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
MHL-080-035
NC
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
MHL-080-035
NC
323P00000X
Psychiatric Residential Treatment Facility
MHL-080-035
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001FY
BCBS
NC
05
—
6603028
—
NC
Enumeration date
12/16/2005
Last updated
01/03/2021
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