Danielle Fowler

Individual provider Active NPI Mental Illness Community Based Residential Treatment Facility · Graham, NC

NPI 1982730263 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1982730263
Entity type
Individual (NPI type 1)
Primary specialty
Mental Illness Community Based Residential Treatment Facility 320800000X
Practice address
324 Walker Ave
Graham, NC 27253-2426
Phone
(336) 226-6449
NPI assigned
Feb 23, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
One More Chance Youth Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Yes

Addresses

Primary practice location

324 Walker Ave
Graham, NC 27253-2426

Mailing address

1018 Moody St
Greensboro, NC 27401-4213

Other providers in Graham, NC

All providers in Graham, NC · Mental Illness Community Based Residential Treatment Facility in North Carolina

Sources for this page

Verify at the official NPI Registry.