Provider Demographics
NPI:1619003605
Name:COUNTY OF CALDWELL
Entity Type:Organization
Organization Name:COUNTY OF CALDWELL
Other - Org Name:CALDWELL CO. HEALTH DEPT.- CBRS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTH DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MICHAUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-426-8415
Mailing Address - Street 1:2345 MORGANTON BLVD SUITE B
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-5311
Mailing Address - Country:US
Mailing Address - Phone:828-426-8400
Mailing Address - Fax:828-426-8450
Practice Address - Street 1:2345 MORGANTON BLVD SW STE B
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-4973
Practice Address - Country:US
Practice Address - Phone:828-426-8400
Practice Address - Fax:828-426-8450
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF CALDWELL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-26
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8300175Medicaid