BARIUM SPRINGS HOME FOR CHILDREN KULYNYCH COTTAGE (NPI# 1033428487) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033428487 |
| Entity Type | Organization |
| Organization Name | BARIUM SPRINGS HOME FOR CHILDREN KULYNYCH COTTAGE |
| Practice Address |
517 Boston Avenue Wilkesboro NC 28659 |
| Mailing Address |
Po Box 1 Barium Springs NC 28010-0001 |
| Practice Telephone | 3366675095 |
| Practice Fax Number | 3369276541 |
| Mailing Telephone | 7048724157 |
| Mailing Fax Number | 7049247683 |
| Enumeration Date | 2010-10-04 |
| Last Update Date | 2010-10-04 |
| Authorized Official Name | MR. JOHN KOPPELMEYER (PRESIDENT/CEO) |
| Authorized Official Telephone | 7048724157 |
| Authorized Official Credential | MSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | NOT YET ASSIGNED | NC | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | NOT YET ASSIGNED | 05 |
| Street Address |
517 BOSTON AVENUE |
| City | WILKESBORO |
| State | NC |
| Zip Code | 28659 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013579689 | Lisa C Carr | Social Worker | 1400 Willow Ln # C61-2, North Wilkesboro, NC 28659 | 2019-07-03 |
| 1780141507 | Brenda Barber | Counselor | 200 Northview Plaza, North Wilkesboro, NC 28659 | 2019-02-28 |
| 1639696941 | Lifespan Incorporated | Community/Behavioral Health | 2070 River Road, North Wilkesboro, NC 28659 | 2017-08-28 |
| 1184146011 | Daymark Recovery Services Inc | Community/Behavioral Health | 200 C.c. Wright School Road, Classrooms 126, 127, North Wilkesboro, NC 28659 | 2017-07-12 |
| 1033568258 | Rgm Al Holdings, LLC | Assisted Living Facility | 240 Independence Ave, North Wilkesboro, NC 28659 | 2016-06-08 |
| 1376997999 | Hayden Church | Driver | 29 Boone Trail, North Wilkesboro, NC 28659 | 2016-04-20 |
| 1033563192 | Nathan Grant Davis | Emergency Medicine | Wake Forest Baptist Health- Wilkes Medical Center, 1370 W D St, North Wilkesboro, NC 28659 | 2016-04-14 |
| 1720425408 | Lindsay Brooke Spears | Dentist | 1915 West Park Drive Ste 104, Wilkes Public Health Dental West, North Wilkesboro, NC 28659 | 2013-06-04 |
| 1881983419 | Pruitthealth Hospice, Inc. | Hospice Care, Community Based | 902 West D St, Ste B, North Wilkesboro, NC 28659 | 2011-04-05 |
| 1275838096 | Barium Springs Home for Children | Community Based Residential Treatment Facility, Mental Illness | 517 Boston Ave, North Wilkesboro, NC 28659 | 2011-01-26 |
| Find all providers in zip 28659 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700898632 | Rainbow Center, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 507 Courthouse Dr, Wilkesboro, NC 28697-2926 | 2006-08-12 |
| 1568614618 | Rainbow Center, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 507 Courthouse Dr, Wilkesboro, NC 28697-2926 | 2008-10-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023617255 | Creative Helping Hands LLC | Residential Treatment Facility, Emotionally Disturbed Children | 478 Green Lake Rd, Rockingham, NC 28379-7850 | 2020-10-19 |
| 1083237986 | Revive Housing LLC | Residential Treatment Facility, Emotionally Disturbed Children | 210 Sunset Dr Apt 615, Salisbury, NC 28147-7147 | 2020-05-26 |
| 1457998627 | Re Health Group | Residential Treatment Facility, Emotionally Disturbed Children | 1102 Groves St, Kings Mountain, NC 28086-2232 | 2019-12-05 |
| 1821631532 | Marquita Latrice Walls | Residential Treatment Facility, Emotionally Disturbed Children | 1565 Longbranch Rd, Grover, NC 28073-9599 | 2019-10-25 |
| 1699233866 | A Brighter Path LLC | Residential Treatment Facility, Emotionally Disturbed Children | 120 Jetter Rd, Grover, NC 28073-9687 | 2019-03-06 |
| 1821562224 | Carter Clinic, Pa | Residential Treatment Facility, Emotionally Disturbed Children | 703 W 3rd Ave Bldg A, Red Springs, NC 28377-1524 | 2019-01-18 |
| 1659842607 | Gervonia Robinson | Residential Treatment Facility, Emotionally Disturbed Children | 1714 Aster Ln, Gastonia, NC 28054-8303 | 2018-12-16 |
| 1679058440 | Miracle Houses Inc | Residential Treatment Facility, Emotionally Disturbed Children | 7827 Kerrybrook Cir, Charlotte, NC 28214-2513 | 2018-09-27 |
| 1174048078 | A Safe Place Community Housing, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 2049 Highland St, Charlotte, NC 28208-4909 | 2017-08-11 |
| 1104346881 | Inspiration for Us | Residential Treatment Facility, Emotionally Disturbed Children | 1205 W Mountain St, Kernersville, NC 27284-2173 | 2017-06-22 |
| Find all providers with the same taxonomy | ||||
| City | WILKESBORO |
| Zip Code | 28659 |
Please comment or provide details below to improve the information on BARIUM SPRINGS HOME FOR CHILDREN KULYNYCH COTTAGE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.