Healthcare Provider Details

I. General information

NPI: 1811195746
Provider Name (Legal Business Name): MENTOR BEHAVIORAL HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 05/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

249 WILSON DR SUITE 5
BOONE NC
28607-8781
US

IV. Provider business mailing address

249 WILSON DR SUITE 5
BOONE NC
28607-8781
US

V. Phone/Fax

Practice location:
  • Phone: 828-268-2172
  • Fax: 828-268-2173
Mailing address:
  • Phone: 828-268-2172
  • Fax: 828-268-2173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number558
License Number StateNC

VIII. Authorized Official

Name: DR. HANK G SCHNEIDER
Title or Position: DIRECTOR
Credential: PH.D.
Phone: 828-268-2172