Provider Demographics
NPI:1629165022
Name:WATAUGA OPPORTUNITIES, INC
Entity Type:Organization
Organization Name:WATAUGA OPPORTUNITIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:F.
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MAYBEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-264-5008
Mailing Address - Street 1:PO BOX 2330
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-2330
Mailing Address - Country:US
Mailing Address - Phone:828-264-5008
Mailing Address - Fax:828-264-5006
Practice Address - Street 1:642 GREENWAY RD
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-4812
Practice Address - Country:US
Practice Address - Phone:828-264-5008
Practice Address - Fax:828-264-5006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL- 095-029251C00000X
NCMHL- 095-020320900000X
NCMHL-095-021320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7802227Medicaid
NC7802228Medicaid
NC3408916Medicaid