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General NPI Number Information
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NPI Number | 1548386220
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Entity Type | Organization
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Legal Business Name | BARIUM SPRINGS HOME FOR CHILDREN
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 08/22/2009
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Provider Practice Location Address
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Address Line | 1711 LANDIS HWY MOORESVILLE INTERMEDIATE DAY TX
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City | MOORESVILLE
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State | NC
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Zip | 28115-6907
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Country | US
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Telephone | 704-873-1011
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Fax | 704-832-2253
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Provider Business Mailing Address
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Address Line | PO BOX 1
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City | BARIUM SPRINGS
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State | NC
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Zip | 28010-0001
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Country | US
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Telephone | 704-873-1011
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Fax | 704-832-2253
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOHN KOPPELMEYER
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Credential |
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Telephone | 704-872-4157
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | MHL049104
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License Number State | NC
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