SOUTHERN HIGHLANDS COMMUNITY MENTAL HEALTH CENTER INC. NPI 1205476488

NPI Information

NPI: 1205476488
Provider Name: SOUTHERN HIGHLANDS COMMUNITY MENTAL HEALTH CENTER, INC.
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 51D1048694

Address:
200 12TH STREET EXT
PRINCETON, WV
ZIP 24740
Phone: (304) 425-9541
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SOUTHERN HIGHLANDS COMMUNITY MENTAL HEALTH CENTER, INC. is a primary care clinic center in Princeton, WV. SOUTHERN HIGHLANDS COMMUNITY MENTAL HEALTH CENTER, INC. NPI is 1205476488. The provider is registered as an organization entity type.

The provider's business location address is:

200 12TH STREET EXT
PRINCETON, WV
ZIP 24740-329
Phone: (304) 425-9541
Fax: (681) 282-5558

The provider's authorized official is Lisa L. Jones .
The authorized official title is Chief Executive Officer and has the following contact phone number (304) 425-9541.

The CLIA number assigned to this NPI record is 51D1048694 - intermediate care facility for mentally retarded with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/15/2020 and was last updated on 1/15/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0005489001	MEDICAID	WEST VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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