Organization
SIXTH AVENUE PSYCHIATRIC REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY JO STARK (OFFICE ADMINISTRATOR)
(828) 697-1581
Entity
Organization
Contact information
Practice address
527 N JUSTICE ST, HENDERSONVILLE, NC 28739-4217
(828) 697-9765
Mailing address
714 6TH AVE W, HENDERSONVILLE, NC 28739-4114
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301703
—
NC
Enumeration date
01/17/2007
Last updated
08/22/2020
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