Provider Demographics
NPI:1215403498
Name:PAVILLON INTERNATIONAL
Entity Type:Organization
Organization Name:PAVILLON INTERNATIONAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:KEATOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-694-2300
Mailing Address - Street 1:241 PAVILLON PL
Mailing Address - Street 2:
Mailing Address - City:MILL SPRING
Mailing Address - State:NC
Mailing Address - Zip Code:28756-5809
Mailing Address - Country:US
Mailing Address - Phone:828-694-2300
Mailing Address - Fax:
Practice Address - Street 1:241 PAVILLON PL
Practice Address - Street 2:
Practice Address - City:MILL SPRING
Practice Address - State:NC
Practice Address - Zip Code:28756-5809
Practice Address - Country:US
Practice Address - Phone:828-694-2300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PAVILLON INTERNATIONAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-16
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility