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General NPI Number Information
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NPI Number | 1740566280
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Entity Type | Organization
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Legal Business Name | DAYMARK RECOVERY SERVICES INC
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Dates
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Enumeration Date | 10/28/2011
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Last Update Date | 03/29/2018
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Provider Practice Location Address
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Address Line | 524 SIGNAL HILL DRIVE EXT
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City | STATESVILLE
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State | NC
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Zip | 28625-4391
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Country | US
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Telephone | 704-871-1045
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Fax |
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Provider Business Mailing Address
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Address Line | 284 EXECUTIVE PARK DRIVE SUITE 100
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City | CONCORD
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State | NC
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Zip | 28025-1894
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Country | US
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Telephone | 704-939-1100
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Fax | 704-939-1173
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. BILLY R WEST JR.
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Credential | M.S.W., L.C.S.W.
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Telephone | 704-939-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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