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General NPI Number Information
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NPI Number | 1356467385
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Entity Type | Organization
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Legal Business Name | GOODWILL INDUSTRIES NWNC
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 124 FOURTH CRESENT PLACE
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City | STATESVILLE
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State | NC
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Zip | 28625
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Country | US
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Telephone | 704-873-5005
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Fax |
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Provider Business Mailing Address
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Address Line | 124 FOURTH CRESENT PLACE
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City | STATESVILLE
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State | NC
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Zip | 28625
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Country | US
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Telephone | 704-873-5005
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Fax |
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Authorized Official
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Title or Position | HICKORY DISTRICT DIRECTOET
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Name | MS. MARY MARGARET PATTON
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Credential | M.E.D.,QP
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Telephone | 704-873-5005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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