Provider Demographics
NPI:1851135735
Name:THE TAMARISK PLACE, INC.
Entity type:Organization
Organization Name:THE TAMARISK PLACE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:CULP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-230-5203
Mailing Address - Street 1:818 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KANNAPOLIS
Mailing Address - State:NC
Mailing Address - Zip Code:28081-4918
Mailing Address - Country:US
Mailing Address - Phone:980-230-5203
Mailing Address - Fax:
Practice Address - Street 1:1410 BOSTON RD
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NC
Practice Address - Zip Code:28658-8661
Practice Address - Country:US
Practice Address - Phone:980-230-5203
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-24
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No251S00000XAgenciesCommunity/Behavioral Health