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Organization

FOOTHILLS BEHAVIORAL HEALTH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LARRY DALE SMITH LCMHC (CLINICAL DIRECTOR)
(336) 303-0585
Entity
Organization

Contact information

Practice address
122 N CAROLINA AVE, BOONVILLE, NC 27011-8934
(336) 303-0585
Mailing address
122 N CAROLINA AVE, BOONVILLE, NC 27011-8934
(336) 303-0585

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1689159196
NC
Enumeration date
08/04/2023
Last updated
11/07/2023
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