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General NPI Number Information
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NPI Number | 1902946411
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Entity Type | Organization
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Legal Business Name | BAPTIST CHILDREN'S HOMES OF NORTH CAROLINA, INC.
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 01/26/2009
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Provider Practice Location Address
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Address Line | 515 WATSON AVE
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City | THOMASVILLE
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State | NC
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Zip | 27360-4540
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Country | US
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Telephone | 336-474-1200
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Fax | 336-472-4110
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Provider Business Mailing Address
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Address Line | 204 IDOL ST P. O BOX 338
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City | THOMASVILLE
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State | NC
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Zip | 27360-4514
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Country | US
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Telephone | 336-474-1276
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Fax | 336-472-4605
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Authorized Official
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Title or Position | TREASURER CFO
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Name | MR. SAMUEL V. BAREFOOT
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Credential |
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Telephone | 336-474-1224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | B00076
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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 | B00076
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License Number State | NC
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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 | B00076
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License Number State | NC
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