| 180 Behavioral Health, Pllc | |
|
496 Morningside Dr. Blowing Rock NC 28605 | |
| (828) 268-4022 | |
| Not Available |
| Full Name | 180 Behavioral Health, Pllc |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 496 Morningside Dr., Blowing Rock, North Carolina |
| Authorized Official Name and Position | Joseph Warren Dickson (CLINICAL SUPERVISOR/OWNER) |
| Authorized Official Contact | 8282684022 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 180 Behavioral Health, Pllc Po Box 1645 Blowing Rock NC 28605-1645 Ph: (828) 268-4022 | 180 Behavioral Health, Pllc 496 Morningside Dr. Blowing Rock NC 28605 Ph: (828) 268-4022 |
| NPI Number | 1760630016 |
|---|---|
| Provider Enumeration Date | 08/28/2008 |
| Last Update Date | 08/28/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760630016 | NPI | - | NPPES |
| 6102765 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | 4632 (North Carolina) | Primary |
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