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General NPI Number Information
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NPI Number | 1558380915
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Entity Type | Organization
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Legal Business Name | MARY BENSON HOUSE - ARP/PHOENIX
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 06/26/2008
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Provider Practice Location Address
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Address Line | 450 MONTFORD AVE
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City | ASHEVILLE
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State | NC
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Zip | 28801-1015
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Country | US
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Telephone | 828-252-5280
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 16367
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City | ASHEVILLE
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State | NC
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Zip | 28816-0367
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Country | US
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Telephone | 828-252-8957
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Fax | 828-255-8028
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | PAUL TAX
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Credential |
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Telephone | 828-254-2700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | MHL011106
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License Number State | NC
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