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General NPI Number Information
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NPI Number | 1639507676
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Entity Type | Organization
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Legal Business Name | HINDS FEET FARM, INC
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Dates
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Enumeration Date | 10/30/2013
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 14645 BLACK FARMS RD.
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City | HUNTERSVILLE
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State | NC
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Zip | 28078
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Country | US
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Telephone | 704-944-1424
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Fax | 704-992-1423
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Provider Business Mailing Address
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Address Line | P.O. BOX 2842
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City | HUNTERSVILLE
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State | NC
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Zip | 28070
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Country | US
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Telephone | 704-944-1424
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Fax | 704-992-1423
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | BETH C. CALLAHAN
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Credential |
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Telephone | 704-992-1424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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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 | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | MHL-060-1257
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License Number State | NC
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