Provider Demographics
NPI:1699268953
Name:BARIUM SPRINGS HOME FOR CHILDREN
Entity type:Organization
Organization Name:BARIUM SPRINGS HOME FOR CHILDREN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CELESTE
Authorized Official - Middle Name:INEZ
Authorized Official - Last Name:DOMINGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-832-2211
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:048-322-2007
Mailing Address - Fax:704-838-1541
Practice Address - Street 1:158 GRANDFATHER HOME DRIVE BLDG 2
Practice Address - Street 2:
Practice Address - City:BANNER ELK
Practice Address - State:NC
Practice Address - Zip Code:28604
Practice Address - Country:US
Practice Address - Phone:828-898-5465
Practice Address - Fax:828-898-8513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-12
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health