| Ads-hickory | |
|
1055 13th St Se Hickory NC 28602-4165 | |
| (828) 449-1020 | |
| (336) 443-1030 |
| Full Name | Ads-hickory |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1055 13th St Se, Hickory, North Carolina |
| Authorized Official Name and Position | Ron C. Rau (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3368128645 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ads-hickory 1055 13th St Se Hickory NC 28602-4165 Ph: (828) 449-1020 | Ads-hickory 1055 13th St Se Hickory NC 28602-4165 Ph: (828) 449-1020 |
| NPI Number | 1063550218 |
|---|---|
| Provider Enumeration Date | 02/01/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063550218 | NPI | - | NPPES |
| 8301010Q | Medicaid | NC | |
| 8301010G | Medicaid | NC | |
| 6005606 | Medicaid | NC | |
| 8301010B | Medicaid | NC | |
| 8301010 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | MHL-018-073 (North Carolina) | Primary |
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