Provider Demographics
NPI:1093136335
Name:BARIUM SPRINGS
Entity Type:Organization
Organization Name:BARIUM SPRINGS
Other - Org Name:CHILDREN'S HOPE ALLIANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CELESTE
Authorized Official - Middle Name:INEZ
Authorized Official - Last Name:DOMINGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-873-2211
Mailing Address - Street 1:194 BARIUM SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28677-8453
Mailing Address - Country:US
Mailing Address - Phone:048-322-2007
Mailing Address - Fax:704-838-1541
Practice Address - Street 1:4344 S NC HIGHWAY 150 STE D
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27295
Practice Address - Country:US
Practice Address - Phone:336-880-1855
Practice Address - Fax:336-553-9175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-03
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty