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General NPI Number Information
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NPI Number | 1942803135
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL HEALTH SOLUTIONS
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Dates
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Enumeration Date | 11/19/2020
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 270 US HIGHWAY 62
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City | BARDWELL
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State | KY
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Zip | 42023
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Country | US
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Telephone | 270-551-4480
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Fax |
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Provider Business Mailing Address
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Address Line | 270 US HIGHWAY 62
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City | BARDWELL
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State | KY
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Zip | 42023
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Country | US
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Telephone | 270-551-4480
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HAIDY WILLIS
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Credential |
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Telephone | 270-551-4480
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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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