Provider Demographics
NPI:1942605332
Name:THE BAIR FOUNDATION-IAFT-108 EXECUTIVE PARK
Entity Type:Organization
Organization Name:THE BAIR FOUNDATION-IAFT-108 EXECUTIVE PARK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF THE SOUTHEAST REGION
Authorized Official - Prefix:MS
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-350-5197
Mailing Address - Street 1:241 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:NEW WILMINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:16142-1116
Mailing Address - Country:US
Mailing Address - Phone:724-946-8711
Mailing Address - Fax:
Practice Address - Street 1:108 EXECUTIVE PARK
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2426
Practice Address - Country:US
Practice Address - Phone:828-350-5197
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-28
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC190253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency