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General NPI Number Information
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NPI Number | 1629165022
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Entity Type | Organization
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Legal Business Name | WATAUGA OPPORTUNITIES, INC
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 09/13/2007
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Provider Practice Location Address
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Address Line | 642 GREENWAY RD
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City | BOONE
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State | NC
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Zip | 28607-4812
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Country | US
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Telephone | 828-264-5008
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Fax | 828-264-5006
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Provider Business Mailing Address
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Address Line | PO BOX 2330
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City | BOONE
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State | NC
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Zip | 28607-2330
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Country | US
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Telephone | 828-264-5008
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Fax | 828-264-5006
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Authorized Official
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Title or Position | PRESIDENT / CEO
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Name | MR. F. MICHAEL MAYBEE
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Credential |
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Telephone | 828-264-5008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | MHL- 095-020
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | MHL-095-021
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License Number State | NC
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Taxonomy #3
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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 | MHL- 095-029
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License Number State | NC
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