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General NPI Number Information
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NPI Number | 1427101559
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Entity Type | Organization
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Legal Business Name | GOLDSTON'S SUBSTANCE ABUSE PROGRAM,INC
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Dates
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Enumeration Date | 01/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 952 S COX ST
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City | ASHEBORO
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State | NC
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Zip | 27203-6466
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Country | US
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Telephone | 336-629-3174
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Fax | 336-629-3584
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Provider Business Mailing Address
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Address Line | 952 S COX ST
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City | ASHEBORO
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State | NC
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Zip | 27203-6466
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Country | US
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Telephone | 336-629-3174
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Fax | 336-629-3584
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Authorized Official
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Title or Position | DIRECTOR
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Name | JOE GOLDSTON
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Credential | LCAS
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Telephone | 336-629-3174
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 11
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License Number State | NC
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