Provider Demographics
NPI:1891452876
Name:THREE POINTS CENTER NORTH CAROLINA
Entity Type:Organization
Organization Name:THREE POINTS CENTER NORTH CAROLINA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:THIBAULT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMFT
Authorized Official - Phone:435-635-0636
Mailing Address - Street 1:1500 E 2700 S
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:UT
Mailing Address - Zip Code:84737-4000
Mailing Address - Country:US
Mailing Address - Phone:435-635-0636
Mailing Address - Fax:435-304-0004
Practice Address - Street 1:990 GLOVERS GROVE CHURCH RD
Practice Address - Street 2:
Practice Address - City:SILER CITY
Practice Address - State:NC
Practice Address - Zip Code:27344-6517
Practice Address - Country:US
Practice Address - Phone:919-214-5763
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THREE POINTS CENTER, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-11-24
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children