Healthcare Provider Details
I. General information
NPI: 1356393284
Provider Name (Legal Business Name): THREE STREAMS FAMILY HEALTH CARE CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/17/2006
Last Update Date: 11/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1710 OLD HAYWOOD RD
ASHEVILLE NC
28806-1154
US
IV. Provider business mailing address
1710 OLD HAYWOOD RD
ASHEVILLE NC
28806-1154
US
V. Phone/Fax
- Phone: 828-285-9725
- Fax: 828-285-9762
- Phone: 828-285-9725
- Fax: 828-285-9762
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251V00000X |
| Taxonomy | Voluntary or Charitable Agency |
| License Number | 33789 |
| License Number State | NC |
VIII. Authorized Official
Name:
GERI
L
SPANGLER
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 828-285-9725