Healthcare Provider Details

I. General information

NPI: 1730716895
Provider Name (Legal Business Name): SOUTHMOUNTAIN CHILDREN AND FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 03/26/2020
Certification Date: 03/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 S GREEN ST
MORGANTON NC
28655-3530
US

IV. Provider business mailing address

PO BOX 3387
MORGANTON NC
28680-3387
US

V. Phone/Fax

Practice location:
  • Phone: 828-430-9949
  • Fax:
Mailing address:
  • Phone: 828-584-1105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LISA MCFARLAND
Title or Position: FINANCE OFFICER
Credential:
Phone: 828-584-1105