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General NPI Number Information
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NPI Number | 1609634377
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Entity Type | Organization
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Legal Business Name | S & S BEHAVIORAL HEALTH, LLC
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Dates
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Enumeration Date | 03/07/2024
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 1907 E PITTSBURG CHURCH RD
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City | LONDON
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State | KY
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Zip | 40741-9047
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Country | US
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Telephone | 606-389-5269
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Fax | 606-389-5276
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Provider Business Mailing Address
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Address Line | 1907 E PITTSBURG CHURCH RD
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City | LONDON
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State | KY
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Zip | 40741-9047
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Country | US
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Telephone | 606-389-5269
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Fax | 606-389-5276
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Authorized Official
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Title or Position | OWNER/CEO
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Name | STEPHANIE ANN SHORT
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Credential | PMHNP-BC
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Telephone | 606-389-5269
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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