Healthcare Provider Details

I. General information

NPI: 1013531037
Provider Name (Legal Business Name): BEHAVIORAL HEALTHCARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2020
Last Update Date: 06/05/2020
Certification Date: 06/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227B HWY 314 NW
LOS LUNAS NM
87031-8476
US

IV. Provider business mailing address

1100 WALNUT ST
OWENSBORO KY
42301-2956
US

V. Phone/Fax

Practice location:
  • Phone: 505-268-0701
  • Fax:
Mailing address:
  • Phone: 270-689-6642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL R HUTH
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 270-689-6642