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General NPI Number Information
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NPI Number | 1417712670
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Entity Type | Organization
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Legal Business Name | BARBARA'S HOUSE
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Dates
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Enumeration Date | 02/16/2024
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Last Update Date | 02/16/2024
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Provider Practice Location Address
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Address Line | 100 MELROSE AVE STE 100
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City | GREENWICH
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State | CT
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Zip | 06830-6277
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Country | US
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Telephone | 203-869-1276
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Fax |
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Provider Business Mailing Address
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Address Line | 10130 MALLARD CREEK RD STE 343
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City | CHARLOTTE
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State | NC
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Zip | 28262-6000
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Country | US
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Telephone | 704-219-4720
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Fax | 888-323-4404
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Authorized Official
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Title or Position | BILLING DIRECTOR
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Name | KEISHA MILLER
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Credential |
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Telephone | 704-219-4720
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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