Provider Demographics
NPI:1497788665
Name:THREE SPRINGS, INC
Entity Type:Organization
Organization Name:THREE SPRINGS, INC
Other - Org Name:THREE SPRINGS OF NORTH CAROLINA
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:E
Authorized Official - Last Name:BALCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-880-3339
Mailing Address - Street 1:PO BOX 1370
Mailing Address - Street 2:
Mailing Address - City:PITTSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27312-1370
Mailing Address - Country:US
Mailing Address - Phone:919-542-1104
Mailing Address - Fax:919-542-5565
Practice Address - Street 1:2480 HADLEY MILL RD
Practice Address - Street 2:
Practice Address - City:PITTSBORO
Practice Address - State:NC
Practice Address - Zip Code:27312-7832
Practice Address - Country:US
Practice Address - Phone:919-542-1104
Practice Address - Fax:919-542-5565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL019004322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6603027Medicaid