Provider Demographics
NPI:1336595347
Name:WAITES AND HARWOOD FAMILY SERVICES, INC.
Entity Type:Organization
Organization Name:WAITES AND HARWOOD FAMILY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:HARWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-712-4151
Mailing Address - Street 1:1071 JENKINS VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDER
Mailing Address - State:NC
Mailing Address - Zip Code:28701-8712
Mailing Address - Country:US
Mailing Address - Phone:828-712-4151
Mailing Address - Fax:
Practice Address - Street 1:1071 JENKINS VALLEY RD
Practice Address - Street 2:
Practice Address - City:ALEXANDER
Practice Address - State:NC
Practice Address - Zip Code:28701-8712
Practice Address - Country:US
Practice Address - Phone:828-712-4151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-09
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children