Provider Demographics
NPI:1124499389
Name:BARIUM SPRINGS HOME FOR CHILDREN
Entity type:Organization
Organization Name:BARIUM SPRINGS HOME FOR CHILDREN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:KOPPELMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-873-1011
Mailing Address - Street 1:PO BOX 1
Mailing Address - Street 2:
Mailing Address - City:BARIUM SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:28010-0001
Mailing Address - Country:US
Mailing Address - Phone:704-873-1011
Mailing Address - Fax:704-832-2253
Practice Address - Street 1:1400 WESTGATE CENTER DR
Practice Address - Street 2:STE 100
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3112
Practice Address - Country:US
Practice Address - Phone:336-837-6171
Practice Address - Fax:336-744-1408
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHILDREN'S HOPE ALLIANCE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-14
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health