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General NPI Number Information
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NPI Number | 1609993203
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Entity Type | Organization
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Legal Business Name | THE MENTAL HEALTH FUND INC
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 09/11/2017
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Provider Practice Location Address
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Address Line | 3060 11TH AVENUE DR SE
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City | HICKORY
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State | NC
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Zip | 28602-8336
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Country | US
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Telephone | 828-695-2150
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Fax | 828-695-2155
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Provider Business Mailing Address
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Address Line | 327 1ST AVE NW
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City | HICKORY
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State | NC
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Zip | 28601-6122
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Country | US
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Telephone | 828-695-5900
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Fax | 828-695-4256
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JOHN M WATERS
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Credential | LCWS
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Telephone | 828-695-5900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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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 | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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Legacy Identifiers
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Identifier #1
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Identifier Code | 3408266
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Identifier Type | MEDICAID
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Identifier State | NC
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Identifier Issuer |
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Proprietary Identifiers Ever Reported
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Identifier #1
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Identifier Code | 3408266
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Identifier Type | MEDICAID
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Identifier State | NC
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Identifier Issuer |
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