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General NPI Number Information
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NPI Number | 1659362911
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Entity Type | Organization
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Legal Business Name | CLAY COMPREHENSIVE HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 11/03/2005
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Last Update Date | 01/05/2011
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Provider Practice Location Address
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Address Line | 241 CHURCH ST
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City | HAYESVILLE
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State | NC
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Zip | 28904-9688
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Country | US
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Telephone | 828-389-6383
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Fax | 828-389-2322
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Provider Business Mailing Address
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Address Line | PO BOX 1309
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City | HAYESVILLE
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State | NC
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Zip | 28904-1309
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Country | US
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Telephone | 828-389-6383
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Fax | 828-389-2322
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | CARIE FREE
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Credential |
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Telephone | 828-389-6383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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