Organization
GOODWILL INDUSTRIES NWNC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MALLA TONGCHY VUE (HICKORY DISTRICT DIRECTOR)
(828) 465-0371
Entity
Organization
Contact information
Practice address
413 THORNBURG DR SE, CONOVER, NC 28613-8845
(828) 465-0371
Mailing address
413 THORNBURG DR SE, CONOVER, NC 28613-8845
(828) 465-0371
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
MHL-018-075
NC
251S00000X
Community/Behavioral Health Agency
MHL-018-075
NC
Other
Enumeration date
03/21/2007
Last updated
10/04/2017
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