Provider Demographics
NPI:1871781690
Name:MITCHELL COUNTY DSS
Entity type:Organization
Organization Name:MITCHELL COUNTY DSS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLTSCLAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-688-2175
Mailing Address - Street 1:347 LONGVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28705-9600
Mailing Address - Country:US
Mailing Address - Phone:828-688-2175
Mailing Address - Fax:828-688-4940
Practice Address - Street 1:347 LONGVIEW DR
Practice Address - Street 2:
Practice Address - City:BAKERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28705-9600
Practice Address - Country:US
Practice Address - Phone:828-688-2175
Practice Address - Fax:828-688-4940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-05
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8700019Medicaid