Provider Demographics
NPI:1356467385
Name:GOODWILL INDUSTRIES NWNC
Entity Type:Organization
Organization Name:GOODWILL INDUSTRIES NWNC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HICKORY DISTRICT DIRECTOET
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:PATTON
Authorized Official - Suffix:
Authorized Official - Credentials:MED,QP
Authorized Official - Phone:704-873-5005
Mailing Address - Street 1:124 FOURTH CRESENT PLACE
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28625
Mailing Address - Country:US
Mailing Address - Phone:704-873-5005
Mailing Address - Fax:
Practice Address - Street 1:124 FOURTH CRESENT PLACE
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28625
Practice Address - Country:US
Practice Address - Phone:704-873-5005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)