Provider Demographics
NPI:1487770236
Name:BARIUM SPRINGS HOME FOR CHILDREN
Entity type:Organization
Organization Name:BARIUM SPRINGS HOME FOR CHILDREN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOPPELMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-872-4157
Mailing Address - Street 1:3628 FALL CREEK CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:JONESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28642-9165
Mailing Address - Country:US
Mailing Address - Phone:704-873-1011
Mailing Address - Fax:704-832-2253
Practice Address - Street 1:3628 FALL CREEK CHURCH RD
Practice Address - Street 2:
Practice Address - City:JONESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28642-9165
Practice Address - Country:US
Practice Address - Phone:704-873-1011
Practice Address - Fax:704-832-2253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2009-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children