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General NPI Number Information
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NPI Number | 1821434739
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Entity Type | Organization
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Legal Business Name | WILLOW PLACE II, INC
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Dates
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Enumeration Date | 05/18/2013
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Last Update Date | 07/09/2021
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Provider Practice Location Address
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Address Line | 30 GARFIELD ST STE A
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City | ASHEVILLE
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State | NC
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Zip | 28803-7301
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Country | US
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Telephone | 828-254-3484
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Fax | 828-254-3485
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Provider Business Mailing Address
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Address Line | 30 GARFIELD ST STE A
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City | ASHEVILLE
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State | NC
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Zip | 28803-7301
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | QA MANAGER
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Name | MRS. NICOLE ELIZABETH CIFUENTES
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Credential |
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Telephone | 561-707-0532
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | MHL-011-366
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License Number State | NC
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