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General NPI Number Information
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NPI Number | 1235540212
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Entity Type | Organization
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Legal Business Name | ANDERSON BEHAVIORAL HEALTH, INC
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Dates
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Enumeration Date | 05/13/2014
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Last Update Date | 12/21/2020
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Provider Practice Location Address
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Address Line | 1915 HASTY ROAD
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City | MARSHVILLE
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State | NC
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Zip | 28103-8103
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Country | US
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Telephone | 704-290-4246
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Fax | 704-749-3842
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Provider Business Mailing Address
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Address Line | 1915 HASTY RD
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City | MARSHVILLE
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State | NC
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Zip | 28103-0029
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Country | US
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Telephone | 704-624-4620
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Fax | 704-624-0667
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Authorized Official
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Title or Position | BILLING SPECIALIST
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Name | DEMETRIC HAILEY
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Credential |
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Telephone | 704-624-4620
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number |
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License Number State |
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