Provider Demographics
NPI:1992851356
Name:CAROLINAS COGNITIVE CARE, INC.
Entity type:Organization
Organization Name:CAROLINAS COGNITIVE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:CALLAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:BSW, MPA
Authorized Official - Phone:828-264-1545
Mailing Address - Street 1:PO BOX 1328
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-1328
Mailing Address - Country:US
Mailing Address - Phone:828-264-1545
Mailing Address - Fax:828-262-5680
Practice Address - Street 1:207 SUNBURST LN
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-6438
Practice Address - Country:US
Practice Address - Phone:828-264-1545
Practice Address - Fax:828-262-5680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty