Healthcare Provider Details
I. General information
NPI: 1104440726
Provider Name (Legal Business Name): BLUE RIDGE HOPE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/29/2020
Last Update Date: 03/01/2026
Certification Date: 03/01/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
314 US HIGHWAY 221A
FOREST CITY NC
28043-5902
US
IV. Provider business mailing address
314 US HIGHWAY 221A
FOREST CITY NC
28043-5902
US
V. Phone/Fax
- Phone: 828-202-3075
- Fax: 828-382-2976
- Phone: 828-202-3075
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
ALLYSON
SMITH
Title or Position: ASSISTANT EXECUTIVE DIRECTOR
Credential:
Phone: 828-429-2221