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General NPI Number Information
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NPI Number | 1487082525
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Entity Type | Organization
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Legal Business Name | HAWK RIDGE THERAPEUTIC CENTER
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Dates
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Enumeration Date | 10/29/2013
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Last Update Date | 10/29/2013
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Provider Practice Location Address
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Address Line | 1998 HENDERSONVILLE RD STE 13
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City | ASHEVILLE
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State | NC
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Zip | 28803-2192
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Country | US
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Telephone | 828-277-7672
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Fax | 828-687-8890
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Provider Business Mailing Address
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Address Line | 1998 HENDERSONVILLE RD SUITE 13
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City | ASHEVILLE
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State | NC
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Zip | 28803-2349
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Country | US
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Telephone | 828-277-7672
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Fax | 828-687-8890
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Authorized Official
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Title or Position | THERAPIST
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Name | MR. MICHAEL K KRIZEK
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Credential | LMBT
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Telephone | 828-277-7672
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | 6304
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License Number State | NC
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