Healthcare Provider Details

I. General information

NPI: 1023191657
Provider Name (Legal Business Name): CALDWELL OPPORTUNITIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 04/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1617 COLLEGE AVE SW
LENOIR NC
28645-5315
US

IV. Provider business mailing address

1617 COLLEGE AVE SW
LENOIR NC
28645-5315
US

V. Phone/Fax

Practice location:
  • Phone: 828-757-5680
  • Fax: 828-757-5676
Mailing address:
  • Phone: 828-757-5680
  • Fax: 828-757-5676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. ABIGAIL C. MARCUM
Title or Position: EXECUTIVE DIRECTOR
Credential: MA, QDDP
Phone: 828-757-5680