Healthcare Provider Details

I. General information

NPI: 1003668187
Provider Name (Legal Business Name): ATS OF NORTH CAROLINA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2024
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

249 RIVER BEND DR STE D-11
GRANITE FALLS NC
28630-9388
US

IV. Provider business mailing address

PO BOX 682669
FRANKLIN TN
37068-2669
US

V. Phone/Fax

Practice location:
  • Phone: 760-710-0968
  • Fax:
Mailing address:
  • Phone: 760-710-2347
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRIAN PHILLIP FARLEY
Title or Position: VP & SECRETARY
Credential:
Phone: 615-716-9335