NPIMap

Organization Active NPI

New River Service Authority

  • Adolescent and Children Mental Health Clinic/Center
  • Marion, NC
National Provider Identifier
1205132008
Registry record updated Jan 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
License
MHL-059-050 Issued in NC
Legal business name
NEW RIVER SERVICE AUTHORITY
Practice address
172 Lukin St
Marion, NC 28752-5245
Phone
(828) 263-5666
Fax
(828) 262-5687
NPI assigned
Jan 27, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Donna G Buchanan
Title
Provider Panel Manager
Phone
(828) 263-5666

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X MHL-059-050 NC Primary

Addresses

Primary practice location

172 Lukin St
Marion, NC 28752-5245

Mailing address

895 State Farm Rd
Suite 508
Boone, NC 28607-4917
Phone (828) 263-5666

Other names 1

  • New River Behavioral HealthCare Doing business as

National Provider Directory

National Provider Directory
Tax ID family
New River Behavioral Healthcare10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

172 Lukin St
Marion, NC 28752
Phone (828) 263-5666

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1296086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296086400000",
    "number": "1205132008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "895 STATE FARM RD",
            "address_2": "SUITE 508",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286074917",
            "telephone_number": "828-263-5666",
            "fax_number": "828-262-5687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 LUKIN ST",
            "city": "MARION",
            "state": "NC",
            "postal_code": "287525245",
            "telephone_number": "828-263-5666",
            "fax_number": "828-262-5687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW RIVER SERVICE AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-27",
        "last_updated": "2011-01-27",
        "status": "A",
        "authorized_official_last_name": "BUCHANAN",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PROVIDER PANEL MANAGER",
        "authorized_official_telephone_number": "828-263-5666"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NC",
            "license": "MHL-059-050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New River Behavioral HealthCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marion, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.