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General NPI Number Information
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NPI Number | 1912059783
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Entity Type | Organization
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Legal Business Name | SIXTH AVENUE PSYCHIATRIC REHABILITATION PARTNERS, INC.
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 06/28/2013
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Provider Practice Location Address
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Address Line | 2110 WOODRIDGE DR
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City | HENDERSONVILLE
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State | NC
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Zip | 28739-3158
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Country | US
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Telephone | 828-697-1581
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Fax | 828-697-4492
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Provider Business Mailing Address
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Address Line | 522 KANUGA RD
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City | HENDERSONVILLE
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State | NC
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Zip | 28739-5226
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Country | US
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Telephone | 828-697-1581
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Fax | 828-697-4492
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Authorized Official
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Title or Position | ADMIN. SERVICES MGR.
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Name | TERESA SMITH DREVAR
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Credential |
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Telephone | 828-489-3893
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | MHL-045-070
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License Number State | NC
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Taxonomy #2
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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 | NC
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