Healthcare Provider Details

I. General information

NPI: 1578091161
Provider Name (Legal Business Name): NCG ACQUISITION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2017
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 VIEW POINTE DR
MURPHY NC
28906-8621
US

IV. Provider business mailing address

PO BOX 11247
RICHMOND VA
23230-1247
US

V. Phone/Fax

Practice location:
  • Phone: 828-837-0071
  • Fax: 828-837-5309
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AMANDA DIXON
Title or Position: CREDENTIALING SUPERVISOR
Credential:
Phone: 910-520-6756