Provider Demographics
NPI:1457493496
Name:CAROLINA TREATMENT ASSOCIATES
Entity Type:Organization
Organization Name:CAROLINA TREATMENT ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SETZER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-324-8191
Mailing Address - Street 1:255 18TH STREET SE
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602
Mailing Address - Country:US
Mailing Address - Phone:828-324-8191
Mailing Address - Fax:828-324-8393
Practice Address - Street 1:255 18TH STREET SE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602
Practice Address - Country:US
Practice Address - Phone:828-324-8191
Practice Address - Fax:828-324-8393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89011V5Medicaid
NC89011V5Medicaid