Provider Demographics
NPI:1720258007
Name:WHITEWATER COVE GROUP HOME, INC.
Entity type:Organization
Organization Name:WHITEWATER COVE GROUP HOME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AKERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-877-3320
Mailing Address - Street 1:3127 HENDERSONVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:PISGAH FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:28768-9269
Mailing Address - Country:US
Mailing Address - Phone:828-877-3320
Mailing Address - Fax:630-559-7528
Practice Address - Street 1:3127 NEW HENDERSONVILLE HWY
Practice Address - Street 2:
Practice Address - City:PISGAH FOREST
Practice Address - State:NC
Practice Address - Zip Code:28768-8611
Practice Address - Country:US
Practice Address - Phone:828-877-3329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children