Provider Demographics
NPI:1588411383
Name:ROCKWELL DEVELOPMENT CENTER, INC
Entity type:Organization
Organization Name:ROCKWELL DEVELOPMENT CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:FOUTS
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-987-2096
Mailing Address - Street 1:PO BOX 94
Mailing Address - Street 2:
Mailing Address - City:BARIUM SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:28010-0094
Mailing Address - Country:US
Mailing Address - Phone:704-987-2096
Mailing Address - Fax:704-919-5590
Practice Address - Street 1:11330 VANSTORY DR STE 115
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-8146
Practice Address - Country:US
Practice Address - Phone:704-987-2096
Practice Address - Fax:704-919-5590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health