Healthcare Provider Details

I. General information

NPI: 1598824856
Provider Name (Legal Business Name): DAVIDSON HOMES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 05/21/2020
Certification Date: 05/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2084 US 70 HWY
SWANNANOA NC
28778
US

IV. Provider business mailing address

2084 US 70 HWY
SWANNANOA NC
28778-8211
US

V. Phone/Fax

Practice location:
  • Phone: 828-299-1720
  • Fax: 828-299-1773
Mailing address:
  • Phone: 828-299-1720
  • Fax: 828-299-1773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number StateNC

VIII. Authorized Official

Name: MR. JOHN M DAVIDSON
Title or Position: PRESIDENT
Credential:
Phone: 828-299-1720