Provider Demographics
NPI:1134978737
Name:AMETHYST CONSULTING & TREATMENT SOLUTIONS, PLLC
Entity type:Organization
Organization Name:AMETHYST CONSULTING & TREATMENT SOLUTIONS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NOEL
Authorized Official - Middle Name:SEBASTIAN
Authorized Official - Last Name:BOST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-674-9781
Mailing Address - Street 1:2706 SAINT JUDE ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-3670
Mailing Address - Country:US
Mailing Address - Phone:336-674-9781
Mailing Address - Fax:
Practice Address - Street 1:310 BIRCH ST
Practice Address - Street 2:
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-3297
Practice Address - Country:US
Practice Address - Phone:470-483-3661
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health