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General NPI Number Information
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NPI Number | 1922434943
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Entity Type | Organization
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Legal Business Name | FIRST STEP FARM OF WESTERN N. C., INC
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Dates
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Enumeration Date | 09/23/2013
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Last Update Date | 09/23/2013
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Provider Practice Location Address
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Address Line | 215 BLACK OAK COVE RD
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City | CANDLER
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State | NC
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Zip | 28715-8139
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Country | US
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Telephone | 828-667-0587
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Fax | 828-665-5606
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Provider Business Mailing Address
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Address Line | 215 BLACK OAK COVE RD
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City | CANDLER
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State | NC
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Zip | 28715-8139
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Country | US
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Telephone | 828-667-0587
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Fax | 828-665-5606
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. J. MICHAEL PLEMMONS
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Credential |
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Telephone | 828-667-0587
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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 011-003/011-080
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License Number State | NC
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