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General NPI Number Information
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NPI Number | 1386292696
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Entity Type | Organization
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Legal Business Name | AJAYA
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Dates
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Enumeration Date | 08/29/2019
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Last Update Date | 04/08/2021
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Provider Practice Location Address
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Address Line | 4010 LITTLEJOHN CHURCH RD
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City | LENOIR
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State | NC
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Zip | 28645-8563
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Country | US
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Telephone | 828-292-6822
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Fax |
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Provider Business Mailing Address
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Address Line | 4010 LITTLEJOHN CHURCH RD
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City | LENOIR
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State | NC
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Zip | 28645-8563
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Country | US
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Telephone | 828-292-6822
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Fax |
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Authorized Official
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Title or Position | FOUNDER/CEO
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Name | CHRIS CAIN
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Credential | MS, QP
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Telephone | 828-292-6822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0800X
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Taxonomy Name | Recovery Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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