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General NPI Number Information
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NPI Number | 1992234660
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Entity Type | Organization
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Legal Business Name | THE SPARC FOUNDATION, INC.
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Dates
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Enumeration Date | 06/07/2017
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 225 E CHESTNUT ST
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City | ASHEVILLE
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State | NC
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Zip | 28801-2577
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Country | US
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Telephone | 828-552-3771
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Fax | 828-319-2812
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Provider Business Mailing Address
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Address Line | 225 E CHESTNUT ST STE 100
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City | ASHEVILLE
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State | NC
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Zip | 28801-2582
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Country | US
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Telephone | 828-552-3771
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Fax | 828-319-2812
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JACKIE LATEK
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Credential |
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Telephone | 828-775-0540
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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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Taxonomy #2
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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