1720030927 NPI number — HIGH PLAINS BEHAVIORAL HEALTH, LP

Table of content: (NPI 1720030927)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720030927 NPI number — HIGH PLAINS BEHAVIORAL HEALTH, LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HIGH PLAINS BEHAVIORAL HEALTH, LP
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:
1720030927
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 415000
Provider Second Line Business Mailing Address:
MSC 410691
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37241-5000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-491-9400
Provider Business Mailing Address Fax Number:
210-491-3517

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3300 S FM 1788
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIDLAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79706-2608
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
432-563-1200
Provider Business Practice Location Address Fax Number:
432-563-8752
Provider Enumeration Date:
05/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ROSS
Authorized Official First Name:
TAMMY
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
432-563-1200

Provider Taxonomy Codes

  • Taxonomy code: 283Q00000X , with the licence number:  008326 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 323P00000X , with the licence number: 856605 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: HH6631 . This is a "BC RTC PROV #" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: HH3809 . This is a "BC IP SA PROV #" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 088528 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: HH0809 . This is a "BC IP PSYCH PROV #" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: NM600381 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".




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