Provider Demographics
NPI:1992834287
Name:CATAWBA RIVER BEHAVIORAN & TREATMENT ASSOCIATES INC.
Entity Type:Organization
Organization Name:CATAWBA RIVER BEHAVIORAN & TREATMENT ASSOCIATES INC.
Other - Org Name:WEST GATE
Other - Org Type:Other Name
Authorized Official - Title/Position:SECTERARY TREASURER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:B
Authorized Official - Last Name:BOSTIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-437-7110
Mailing Address - Street 1:PO BOX 1453
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28680-1453
Mailing Address - Country:US
Mailing Address - Phone:828-437-7110
Mailing Address - Fax:828-438-3809
Practice Address - Street 1:3285 WESTGATE DR
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-7960
Practice Address - Country:US
Practice Address - Phone:828-437-7110
Practice Address - Fax:828-438-3809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC012097322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6603831OtherPROVIDER NUMBER