Healthcare Provider Details
I. General information
NPI: 1962726380
Provider Name (Legal Business Name): WESTERN CAROLINA TREATMENT CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/15/2010
Last Update Date: 02/27/2024
Certification Date: 02/27/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3 DOCTORS PARK STE G
ASHEVILLE NC
28801-4521
US
IV. Provider business mailing address
3523 PELHAM RD STE C
GREENVILLE SC
29615-4191
US
V. Phone/Fax
- Phone: 828-251-1478
- Fax: 828-251-5227
- Phone: 864-527-1250
- Fax: 864-203-2066
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1835P1200X |
| Taxonomy | Pharmacotherapy Pharmacist |
| License Number | NC-AW00001420 |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | MHL-011-246 |
| License Number State | NC |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0405X |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM2800X |
| Taxonomy | Methadone Clinic |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
JOY
BAILLEY
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 864-527-1250