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General NPI Number Information
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NPI Number | 1720425168
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Entity Type | Organization
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Legal Business Name | SOLSTICE EAST, LLC
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Dates
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Enumeration Date | 05/24/2013
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Last Update Date | 05/24/2013
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Provider Practice Location Address
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Address Line | 530 UPPER FLAT CREEK RD
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City | WEAVERVILLE
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State | NC
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Zip | 28787-8331
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Country | US
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Telephone | 828-484-9928
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Fax | 877-219-7006
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Provider Business Mailing Address
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Address Line | 530 UPPER FLAT CREEK RD
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City | WEAVERVILLE
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State | NC
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Zip | 28787-8331
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Country | US
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Telephone | 828-484-9928
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Fax | 877-219-7006
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. KYLE STEPHEN GILLETT
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Credential | PH.D., LMFT
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Telephone | 801-913-8795
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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