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General NPI Number Information
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NPI Number | 1710026679
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Entity Type | Organization
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Legal Business Name | SIPES ORCHARD HOME
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 4431 COUNTY HOME RD
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City | CONOVER
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State | NC
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Zip | 28613-9641
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Country | US
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Telephone | 828-256-5056
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Fax | 828-256-4031
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Provider Business Mailing Address
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Address Line | 4431 COUNTY HOME RD
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City | CONOVER
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State | NC
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Zip | 28613-9641
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Country | US
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Telephone | 828-256-5056
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Fax | 828-256-4031
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Authorized Official
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Title or Position | CEOPRESIDENT
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Name | MR. BRIAN L PHELPS
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Credential | ED.D
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Telephone | 828-256-5056
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | MHL-018065
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | MHL-018080
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | MHL-018063
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License Number State | NC
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