Organization
BARIUM SPRINGS HOME FOR CHILDREN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CELESTE INEZ DOMINGUEZ (PRESIDENT/CEO)
(704) 832-2211
Entity
Organization
Contact information
Practice address
115 BARIUM SPRINGS DRIVE, NELSON HOME, STATESVILLE, NC 28677-6238
(704) 873-1011
(704) 924-7683
Mailing address
PO BOX 1, BARIUM SPRINGS, NC 28010-0001
(704) 873-1011
(704) 832-2253
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6604208
—
NC
01
—
MHL-049-109
MH LICENSE
NC
Enumeration date
05/25/2007
Last updated
07/11/2018
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