Basic Information
Provider Information
NPI: 1639455991
EntityType: 2
ReplacementNPI:  
OrganizationName: ATS OF NORTH CAROLINA, LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: MOUNTAIN HEALTH SOLUTIONS ASHEVILLE
OtherOrganizationType: 3
OtherLastName:  
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Mailing Information
Address1: 6183 PASEO DEL NORTE, STE 200
Address2:  
City: CARLSBAD
State: CA
PostalCode: 920111155
CountryCode: US
TelephoneNumber: 8552592288
FaxNumber: 8775520439
Practice Location
Address1: 2 MCDOWELL STREET
Address2: STE. A
City: ASHEVILLE
State: NC
PostalCode: 288014104
CountryCode: US
TelephoneNumber: 8282256050
FaxNumber: 8282256051
Other Information
ProviderEnumerationDate: 10/31/2011
LastUpdateDate: 11/03/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: RICHARDSON
AuthorizedOfficialFirstName: STACY
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CREDENTIALING COORDINATOR
AuthorizedOfficialTelephone: 7607102347
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: ACADIA HEALTHCARE COMPANY, INC.
AuthorizedOfficialNamePrefix:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 11/03/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YA0400XMHL011335NCN193200000X MULTI-SPECIALTY GROUPBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
251S00000X  N AgenciesCommunity/Behavioral Health 
261QM2800XMHL011335NCY Ambulatory Health Care FacilitiesClinic/CenterMethadone Clinic

No ID Information.


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