Organization
FOOTHILLS MENTAL HEALTH DETOX
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIANNE KELLER (REIMBURSEMENT SUPERVISOR)
(828) 430-7148
Entity
Organization
Contact information
Practice address
115 WAMSUTTA MILL RD, MORGANTON, NC 28655-5552
(828) 430-7148
Mailing address
2130 NC 18 US 64, MORGANTON, NC 28655-9373
(828) 430-7148
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301641
—
NC
Enumeration date
03/30/2007
Last updated
08/30/2007
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