1558086363 NPI number — VETERANS PSYCHIATRIC SERVICES LLC

Table of content: (NPI 1558086363)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558086363 NPI number — VETERANS PSYCHIATRIC SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VETERANS PSYCHIATRIC SERVICES LLC
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:
1558086363
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/26/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2370 WINDOM PEAK SMT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CONNELLY SPRINGS
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28612-8340
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
937-594-1142
Provider Business Mailing Address Fax Number:
937-860-2194

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
401 US HIGHWAY 62 S UNIT C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HILLSBORO
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45133-6754
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
937-594-1142
Provider Business Practice Location Address Fax Number:
937-860-2194
Provider Enumeration Date:
10/05/2022

Additional Information

Authorized Official

Authorized Official Last Name:
BARNES
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
937-594-1142

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com