Healthcare Provider Details

I. General information

NPI: 1427102797
Provider Name (Legal Business Name): MITCHELL COUNTY DEPARTMENT OF SOCIAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

347 LONGVIEW DR
BAKERSVILLE NC
28705-9600
US

IV. Provider business mailing address

347 LONGVIEW DR
BAKERSVILLE NC
28705-9600
US

V. Phone/Fax

Practice location:
  • Phone: 828-688-2175
  • Fax: 828-688-4940
Mailing address:
  • Phone: 828-688-2175
  • Fax: 828-688-4940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License NumberHC0684
License Number StateNC

VIII. Authorized Official

Name: MR. LARRY DEYTON
Title or Position: DIRECTOR
Credential:
Phone: 828-688-2175