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General NPI Number Information
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NPI Number | 1497706659
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Entity Type | Organization
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Legal Business Name | HIGHLAND HOSPITAL ASSOCIATION
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Dates
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Enumeration Date | 05/13/2006
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Last Update Date | 04/12/2013
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Provider Practice Location Address
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Address Line | 300 56TH ST SE
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City | CHARLESTON
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State | WV
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Zip | 25304-2308
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Country | US
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Telephone | 304-926-1600
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Fax | 304-926-1649
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Provider Business Mailing Address
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Address Line | 300 56TH ST SE
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City | CHARLESTON
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State | WV
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Zip | 25304-2308
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Country | US
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Telephone | 304-926-1600
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Fax | 304-926-1649
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | MR. JAMES H. DISSEN
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Credential |
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Telephone | 304-348-1401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | 151
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License Number State | WV
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