| Catawba Valley Resource Llc | |
|
63 Duke St Granite Falls NC 28630-1850 | |
| (828) 430-1537 | |
| Not Available |
| Full Name | Catawba Valley Resource Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 63 Duke St, Granite Falls, North Carolina |
| Authorized Official Name and Position | James Grey Johnson (OWNER) |
| Authorized Official Contact | 8284301537 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Catawba Valley Resource Llc 63 Duke St Granite Falls NC 28630-1850 Ph: (828) 430-1537 | Catawba Valley Resource Llc 63 Duke St Granite Falls NC 28630-1850 Ph: (828) 430-1537 |
| NPI Number | 1457006520 |
|---|---|
| Provider Enumeration Date | 02/17/2022 |
| Last Update Date | 01/26/2024 |
| Certification Date | 01/26/2024 |
| Medicare PECOS PAC ID | 4981042264 |
|---|---|
| Medicare Enrollment ID | O20240405000297 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457006520 | NPI | - | NPPES |
| Provider Name | Amy H Rudd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306184106 PECOS PAC ID: 7517180219 Enrollment ID: I20140528000612 |
| Provider Name | James Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912181918 PECOS PAC ID: 4880032168 Enrollment ID: I20240405000393 |
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