=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861521056
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CATAWBA COUNTY SOCIAL SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/05/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3030 11TH AVENUE DR SE
-----------------------------------------------------
City | HICKORY
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28602-8336
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-695-5600
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 669
-----------------------------------------------------
City | NEWTON
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28658-0669
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-695-5600
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | MR. BOBBY K BOYD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 828-695-5603
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251B00000X
-----------------------------------------------------
Taxonomy Name | Case Management Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------