Healthcare Provider Details

I. General information

NPI: 1871828103
Provider Name (Legal Business Name): THE MENTAL HEALTH FUND INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2009
Last Update Date: 09/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 EASTSIDE DR
NEWTON NC
28658-1933
US

IV. Provider business mailing address

3050 11TH AVENUE DR SE
HICKORY NC
28602-8336
US

V. Phone/Fax

Practice location:
  • Phone: 828-695-5900
  • Fax: 828-695-4256
Mailing address:
  • Phone: 828-695-5900
  • Fax: 828-695-4256

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 Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN M WATERS
Title or Position: DIRECTOR
Credential: LCSW
Phone: 828-695-5900