Provider Demographics
NPI:1730499674
Name:MOUNTAIN DISCOVERY CHARTER SCHOOL
Entity Type:Organization
Organization Name:MOUNTAIN DISCOVERY CHARTER SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALDROP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-488-1222
Mailing Address - Street 1:890 JENKINS BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:BRYSON CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28713
Mailing Address - Country:US
Mailing Address - Phone:828-488-1222
Mailing Address - Fax:828-488-0256
Practice Address - Street 1:890 JENKINS BRANCH RD
Practice Address - Street 2:
Practice Address - City:BRYSON CITY
Practice Address - State:NC
Practice Address - Zip Code:28713
Practice Address - Country:US
Practice Address - Phone:828-488-1222
Practice Address - Fax:828-488-0256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-13
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty