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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