Healthcare Provider Details

I. General information

NPI: 1144774514
Provider Name (Legal Business Name): HIGHLAND HEALTH PROVIDERS CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2016
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1487 N HIGH ST
HILLSBORO OH
45133-8496
US

IV. Provider business mailing address

1275 N HIGH ST
HILLSBORO OH
45133-8273
US

V. Phone/Fax

Practice location:
  • Phone: 937-393-3406
  • Fax: 937-393-0511
Mailing address:
  • Phone: 937-393-6101
  • Fax: 937-393-6278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateOH

VIII. Authorized Official

Name: MEGHANN ACKLEY
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 937-840-6617