Organization
SYNERGY RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARL YATES SPAKE MA,CCS,CSAC (DIRECTOR)
(336) 667-7191
Entity
Organization
Contact information
Practice address
118 PEACE ST, NORTH WILKESBORO, NC 28659-4519
(336) 667-7191
(336) 667-6859
Mailing address
PO BOX 26, WILKESBORO, NC 28697-0026
(336) 667-7191
(336) 667-6859
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
MHL097003
NC
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
MHL-097-003
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301254
—
NC
Enumeration date
09/14/2006
Last updated
09/01/2016
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