Basic Information
| Provider Information | |||||||||
| NPI: | 1962726380 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WESTERN CAROLINA TREATMENT CENTER, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3523 PELHAM RD STE C | ||||||||
| Address2: | |||||||||
| City: | GREENVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296154191 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8645271250 | ||||||||
| FaxNumber: | 8642032066 | ||||||||
| Practice Location | |||||||||
| Address1: | 3 DOCTORS PARK STE G | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288014521 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282511478 | ||||||||
| FaxNumber: | 8282515227 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/15/2010 | ||||||||
| LastUpdateDate: | 05/03/2022 | ||||||||
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| AuthorizedOfficialLastName: | BAILLEY | ||||||||
| AuthorizedOfficialFirstName: | JOY | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHIEF OPERATING OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 8645271250 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| NPICertificationDate: | 05/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1835P1200X | NC-AW00001420 | NC | N | 193200000X MULTI-SPECIALTY GROUP | Pharmacy Service Providers | Pharmacist | Pharmacotherapy | 251S00000X | MHL-011-246 | NC | Y | Agencies | Community/Behavioral Health |
No ID Information.