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General NPI Number Information
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NPI Number | 1376180216
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Entity Type | Organization
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Legal Business Name | HIGHLANDS MINDCARE, PLLC
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Dates
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Enumeration Date | 12/10/2019
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Last Update Date | 10/16/2023
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Provider Practice Location Address
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Address Line | 28 MIDWAY ST. SUITE 1
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City | BRISTOL
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State | TN
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Zip | 37620
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Country | US
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Telephone | 423-764-2165
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Fax | 423-217-0779
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Provider Business Mailing Address
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Address Line | 28 MIDWAY ST. SUITE 1
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City | BRISTOL
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State | TN
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Zip | 37620
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Country | US
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Telephone | 423-764-2165
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Fax | 423-217-0779
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Authorized Official
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Title or Position | FACILITY DIRECTOR
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Name | JENNIFER JANE KEITH
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Credential |
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Telephone | 423-764-2165
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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