Organization
SUWS OF THE CAROLINAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS KAREN NILSEN (ADMINISTRATIVE ASSISTANT)
(828) 668-7590
Entity
Organization
Contact information
Practice address
363 GRAPHITE RD, OLD FORT, NC 28762-9455
(828) 668-7590
(828) 668-3162
Mailing address
363 GRAPHITE RD, OLD FORT, NC 28762-9455
(828) 668-7590
(828) 668-3162
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-059-032
NC
3245S0500X
Children's Substance Abuse Rehabilitation Facility
MHL-059-032
NC
Other
Enumeration date
07/26/2007
Last updated
07/26/2007
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