Provider Demographics
NPI:1568659084
Name:ARP PHOENIX - CALDWELL
Entity Type:Organization
Organization Name:ARP PHOENIX - CALDWELL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:TAX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-254-2700
Mailing Address - Street 1:257 BILTMORE AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4158
Mailing Address - Country:US
Mailing Address - Phone:828-254-2700
Mailing Address - Fax:828-254-1524
Practice Address - Street 1:257 BILTMORE AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4158
Practice Address - Country:US
Practice Address - Phone:828-254-2700
Practice Address - Fax:828-254-1524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-28
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8300550Medicaid