MEDICARE: HIGHLANDS TREATMENT CENTER, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1306574850
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIGHLANDS TREATMENT CENTER, LLC

Provider Business Mailing Address
First Line	:	1855 BOWLES AVE STE 210
Second Line	:
City	:	FENTON
State	:	MO
Zip	:	63026-1900
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6767 OLD MADISON PIKE NW
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35806-2172
Country	:	US
Telephone Number	:	636-779-1444
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF CLIENT ACCOUNTS
Name	:	HEATHER WILHELM
Credential	:
Telephone Number	:	314-222-7441

Provider Enumeration Date	:	08/11/2022
Last Update Date	:	10/10/2023

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