Provider Demographics
| NPI: | 1629599717 |
|---|---|
| Name: | CHEROKEE INDIAN HOSPITAL AUTHORITY |
| Entity type: | Organization |
| Organization Name: | CHEROKEE INDIAN HOSPITAL AUTHORITY |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | REVENUE CYCLE MANAGER |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | JENNIFER |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | REED |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 828-497-9163 |
| Mailing Address - Street 1: | PO BOX 63077 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | CHARLOTTE |
| Mailing Address - State: | NC |
| Mailing Address - Zip Code: | 28263-3077 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 828-497-9163 |
| Mailing Address - Fax: | 828-497-1723 |
| Practice Address - Street 1: | 2670 CORNSILK BRANCH RD |
| Practice Address - Street 2: | |
| Practice Address - City: | ROBBINSVILLE |
| Practice Address - State: | NC |
| Practice Address - Zip Code: | 28771-2877 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 828-346-6000 |
| Practice Address - Fax: | 828-346-6001 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | Yes |
| Parent Organization LBN: | CHEROKEE INDIAN HOSPITAL AUTHORITY |
| Parent Organization TIN: | <UNAVAIL> |
| Enumeration Date: | 2017-06-29 |
| Last Update Date: | 2023-12-07 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| 251S00000X, 101YA0400X, 261QM0801X, 101YM0800X, 1041C0700X, 251B00000X, 261QM0850X, 261QR0405X, 282N00000X, 320800000X, 261QM0855X, 261QM1300X, 324500000X | ||
| NC | 320800000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | ||
| No | 251S00000X | Agencies | Community/Behavioral Health | Group - Multi-Specialty | |
| No | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
| No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | Group - Multi-Specialty |
| No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
| No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
| No | 251B00000X | Agencies | Case Management | ||
| No | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health | Group - Multi-Specialty |
| No | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder | Group - Multi-Specialty |
| No | 282N00000X | Hospitals | General Acute Care Hospital | Group - Multi-Specialty | |
| No | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health | |
| No | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | |
| No | 324500000X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility |
