Provider Demographics
NPI:1902079098
Name:MOUNTAIN AREA RECOVERY CENTER
Entity Type:Organization
Organization Name:MOUNTAIN AREA RECOVERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:INGLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-252-8748
Mailing Address - Street 1:PO BOX 3282
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28802-3282
Mailing Address - Country:US
Mailing Address - Phone:828-252-8748
Mailing Address - Fax:828-252-9512
Practice Address - Street 1:414 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:NC
Practice Address - Zip Code:28721-8026
Practice Address - Country:US
Practice Address - Phone:828-454-0560
Practice Address - Fax:828-456-8009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL044043101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5902776Medicaid