Healthcare Provider Details

I. General information

NPI: 1992919948
Provider Name (Legal Business Name): FOCUS POINT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 10/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 MILL CREEK DR
KINGS MTN NC
28086-3898
US

IV. Provider business mailing address

129 MILL CREEK DR
KINGS MTN NC
28086-3898
US

V. Phone/Fax

Practice location:
  • Phone: 704-363-1309
  • Fax: 704-782-9299
Mailing address:
  • Phone: 704-363-1309
  • Fax: 704-782-9299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License NumberMHL-023-139
License Number StateNC

VIII. Authorized Official

Name: KENYATTA WADDELL
Title or Position: PRESIDENT
Credential:
Phone: 704-363-1309