1598882193 NPI number — THE MENTAL HEALTH FUND INC

Table of content: (NPI 1598882193)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598882193 NPI number — THE MENTAL HEALTH FUND INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE MENTAL HEALTH FUND 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:
1598882193
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/23/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
327 1ST AVE NW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HICKORY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28601-6122
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-695-5900
Provider Business Mailing Address Fax Number:
828-695-4256

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1679 US HWY 321 S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28658-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-695-5900
Provider Business Practice Location Address Fax Number:
828-695-4256
Provider Enumeration Date:
03/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
WATERS
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
M
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
828-695-5900

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 8300384S , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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