MEDICARE: BEHAVIORAL HEALTHCARE SERVICES, INC.

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497890818
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEHAVIORAL HEALTHCARE SERVICES, INC.

Provider Business Mailing Address
First Line	:	PO BOX 1637
Second Line	:
City	:	OWENSBORO
State	:	KY
Zip	:	42302-1637
Country	:	US
Telephone Number	:	270-689-6500
Fax Number	:

Provider Business Practice Location Address
First Line	:	2425 S 17TH ST
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28401-7903
Country	:	US
Telephone Number	:	910-313-3232
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	J. MICHAEL MOUNTAIN
Credential	:
Telephone Number	:	270-689-6500

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	11/17/2009

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