Provider Demographics
NPI:1730367103
Name:FOOTHILLS AREA PROGRAM
Entity type:Organization
Organization Name:FOOTHILLS AREA PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUBSTANCE ABUSE COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:CALLAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:CSAC, QMHP
Authorized Official - Phone:828-438-6230
Mailing Address - Street 1:207 N ANDERSON ST
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-3736
Mailing Address - Country:US
Mailing Address - Phone:828-437-6230
Mailing Address - Fax:828-438-6219
Practice Address - Street 1:207 N ANDERSON ST
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-3736
Practice Address - Country:US
Practice Address - Phone:828-437-6230
Practice Address - Fax:828-438-6219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1535101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty