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General NPI Number Information
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NPI Number | 1679681605
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Entity Type | Organization
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Legal Business Name | UNIVERSAL BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 02/21/2013
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Provider Practice Location Address
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Address Line | 101 MEDICAL HEIGHTS DR
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City | FRANKFORT
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State | KY
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Zip | 40601-4137
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Country | US
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Telephone | 502-696-9543
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 896
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City | WINCHESTER
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State | KY
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Zip | 40392-0896
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Country | US
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Telephone | 859-737-0904
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Fax | 859-737-0902
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | DAVID L. CARTER
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Credential |
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Telephone | 859-737-0904
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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