| Foothills Behavioral Health | |
|
122 N Carolina Ave Boonville NC 27011-8934 | |
| (336) 303-0585 | |
| Not Available |
| Full Name | Foothills Behavioral Health |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 122 N Carolina Ave, Boonville, North Carolina |
| Authorized Official Name and Position | Larry Dale Smith (CLINICAL DIRECTOR) |
| Authorized Official Contact | 3363030585 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Foothills Behavioral Health 122 N Carolina Ave Boonville NC 27011-8934 Ph: (336) 303-0585 | Foothills Behavioral Health 122 N Carolina Ave Boonville NC 27011-8934 Ph: (336) 303-0585 |
| NPI Number | 1619659026 |
|---|---|
| Provider Enumeration Date | 08/04/2023 |
| Last Update Date | 11/07/2023 |
| Certification Date | 11/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619659026 | NPI | - | NPPES |
| 1689159196 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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