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General NPI Number Information
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NPI Number | 1942759030
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Entity Type | Organization
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Legal Business Name | DAYMARK RECOVERY SERVICES INC
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Dates
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Enumeration Date | 09/29/2016
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Last Update Date | 03/29/2018
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Provider Practice Location Address
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Address Line | 190 MULBERRY SCHOOL RD CLASSROOMS 139, 141
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City | N WILKESBORO
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State | NC
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Zip | 28659-9112
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Country | US
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Telephone | 704-939-1133
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Fax | 704-983-2636
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Provider Business Mailing Address
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Address Line | 284 EXECUTIVE PARK DRIVE SUITE 100
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City | CONCORD
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State | NC
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Zip | 28025-1833
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Country | US
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Telephone | 704-939-1100
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Fax | 704-939-1173
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Authorized Official
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Title or Position | PRESIDENT, CEO
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Name | MR. BILLY RAY WEST JR.
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Credential | MSW,LCSW
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Telephone | 704-939-1100
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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 |
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License Number State |
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