Provider Demographics
NPI:1366637753
Name:QUALITY MENTAL HEALTH
Entity Type:Organization
Organization Name:QUALITY MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:GOULD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-754-1366
Mailing Address - Street 1:210 MULBERRY ST SW
Mailing Address - Street 2:SUITE D
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-5450
Mailing Address - Country:US
Mailing Address - Phone:828-754-1366
Mailing Address - Fax:866-424-7390
Practice Address - Street 1:210 MULBERRY ST SW
Practice Address - Street 2:SUITE D
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-5450
Practice Address - Country:US
Practice Address - Phone:828-754-1366
Practice Address - Fax:866-424-7390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8300643Medicaid