Second Nature Blue Ridge Carolina
Organization Active NPI Mental Illness Community Based Residential Treatment Facility · Otto, NC
NPI 1124301676 · NPPES record last updated Sep 21, 2011
Key facts
- NPI
- 1124301676
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Illness Community Based Residential Treatment Facility 320800000X
- License
- MHL056024 (NC)
- Legal business name
- SECOND NATURE BLUE RIDGE CAROLINA
- Practice address
- 16 Swiss Village Road
Otto, NC 28763 - Phone
- (706) 212-2037
- NPI assigned
- Sep 21, 2011
- Organization subpart
- No
Authorized official
- Name
- Dan McDougal
- Title
- Program Director
- Phone
- (706) 212-2037
Practitioners 1
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Illness Community Based Residential Treatment Facility | 320800000X | MHL056024 | NC | Yes |
Addresses
Primary practice location
16 Swiss Village Road
Otto, NC 28763
Mailing address
PO Box 809
Clayton, GA 30525-0021
Other providers in Otto, NC
- Anglin Classic Cars, Inc.
- Avril G. E Bowens
- Carla Shorts
- Emily Smith
- Still Blessed, Inc
- Tammy Lee Stingone
All providers in Otto, NC · Mental Illness Community Based Residential Treatment Facility in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 21, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.