| Julian F. Keith Adatc Outpatient Services | |
|
201 Tabernacle Rd Black Mountain NC 28711-2526 | |
| (828) 257-6200 | |
| (828) 257-6300 |
| Full Name | Julian F. Keith Adatc Outpatient Services |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 201 Tabernacle Rd, Black Mountain, North Carolina |
| Authorized Official Name and Position | Karen Burkes (DIVISION DIRECTOR) |
| Authorized Official Contact | 9198554700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Julian F. Keith Adatc Outpatient Services 201 Tabernacle Rd Black Mountain NC 28711-2526 Ph: (828) 257-6200 | Julian F. Keith Adatc Outpatient Services 201 Tabernacle Rd Black Mountain NC 28711-2526 Ph: (828) 257-6200 |
| NPI Number | 1528667763 |
|---|---|
| Provider Enumeration Date | 10/20/2020 |
| Last Update Date | 10/17/2024 |
| Certification Date | 10/17/2024 |
| Medicare PECOS PAC ID | 6103080437 |
|---|---|
| Medicare Enrollment ID | O20221116001053 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528667763 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Amy C Nicholson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043389224 PECOS PAC ID: 8921035312 Enrollment ID: I20050718000487 |
| Provider Name | Steven Donald Buser |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922016773 PECOS PAC ID: 9234239716 Enrollment ID: I20110816000481 |
| Provider Name | Leonard Lee Cruz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831107689 PECOS PAC ID: 7517138811 Enrollment ID: I20110917000020 |
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