Basic Information
| Provider Information | |||||||||
| NPI: | 1508016957 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DISCOVERY HOUSE-NC, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6185 PASEO DEL NORTE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | CARLSBAD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8552592288 | ||||||||
| FaxNumber: | 8775520439 | ||||||||
| Practice Location | |||||||||
| Address1: | 2710 W. STATE STREET | ||||||||
| Address2: | ROUTE 224 | ||||||||
| City: | NEW CASTLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 16101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7245987999 | ||||||||
| FaxNumber: | 7245987998 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/23/2008 | ||||||||
| LastUpdateDate: | 02/12/2021 | ||||||||
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| AuthorizedOfficialLastName: | SANDERSON | ||||||||
| AuthorizedOfficialFirstName: | KIM | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT, CTC DIVISION | ||||||||
| AuthorizedOfficialTelephone: | 8552592288 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | ACADIA HEALTHCARE COMPANY, INC | ||||||||
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| NPICertificationDate: | 02/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251B00000X | N | Agencies | Case Management | 261QM2800X | 3770200 | PA | N | Ambulatory Health Care Facilities | Clinic/Center | Methadone Clinic | 261QM0801X | 3770200 | PA | Y | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
No ID Information.