Healthcare Provider Details

I. General information

NPI: 1609023951
Provider Name (Legal Business Name): COMMUNITY SERVICES FOR CHILDREN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2008
Last Update Date: 08/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1796 HENDERSONVILLE RD
ASHEVILLE NC
28803-2498
US

IV. Provider business mailing address

PO BOX 98
BANNER ELK NC
28604-0098
US

V. Phone/Fax

Practice location:
  • Phone: 828-898-5465
  • Fax:
Mailing address:
  • Phone: 828-898-5465
  • Fax: 828-898-6140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4244
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC005821
License Number StateNC

VIII. Authorized Official

Name: MR. JIM SWINKOLA
Title or Position: CEO
Credential:
Phone: 828-898-5465