Provider Demographics
NPI:1821115221
Name:BARIUM SPRINGS HOME FOR CHILDREN
Entity Type:Organization
Organization Name:BARIUM SPRINGS HOME FOR CHILDREN
Other - Org Name:CHILDREN'S HOPE ALLIANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CELESTE
Authorized Official - Middle Name:INEZ
Authorized Official - Last Name:DOMINGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-832-2211
Mailing Address - Street 1:194 BARIUM SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28677-8453
Mailing Address - Country:US
Mailing Address - Phone:704-832-2200
Mailing Address - Fax:704-838-1541
Practice Address - Street 1:209 BARIUM SPRINGS DRIVE
Practice Address - Street 2:MULTI SPECIALTY GROUP
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28677
Practice Address - Country:US
Practice Address - Phone:704-873-1011
Practice Address - Fax:704-924-7683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6005182Medicaid