1437352945 NPI number — BEHAVIORAL HEALTH ASSOCIATES, INC.

Table of content: (NPI 1437352945)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437352945 NPI number — BEHAVIORAL HEALTH ASSOCIATES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BEHAVIORAL HEALTH ASSOCIATES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437352945
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/18/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2082 OLD GRUBBY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SOUTH BOSTON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24592-6136
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
434-575-8255
Provider Business Mailing Address Fax Number:
434-572-1616

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
515 YANCEY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTH BOSTON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24592
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-575-8255
Provider Business Practice Location Address Fax Number:
434-572-1616
Provider Enumeration Date:
06/11/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ROSE
Authorized Official First Name:
JANE
Authorized Official Middle Name:
C
Authorized Official Title or Position:
OWNER/PROVIDER
Authorized Official Telephone Number:
434-575-8255

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 343900000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 260642000 . This is a "MAGELLAN" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 237752 . This is a "VALUE OPTIONS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 087374 . This is a "OPTIMA SENTARA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 326561 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 98581393 . This is a "UNITED BEHAVIORAL HEALTH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 008917531 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 326561 . This is a "ANTHEM HEALTHKEEPERS PLUE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 165713000 . This is a "MAGELLAN" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 98581393 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com