Provider Demographics
NPI:1003397878
Name:HBS OF MERIDIAN, LLC
Entity Type:Organization
Organization Name:HBS OF MERIDIAN, LLC
Other - Org Name:COTTONWOOD CREEK BEHAVIORAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP/SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:JANIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:PICKLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-393-8809
Mailing Address - Street 1:3102 WEST END AVENUE
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1324
Mailing Address - Country:US
Mailing Address - Phone:615-393-8800
Mailing Address - Fax:615-393-8844
Practice Address - Street 1:2131 S BONITO WAY
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-1659
Practice Address - Country:US
Practice Address - Phone:208-202-4700
Practice Address - Fax:208-629-1711
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HAVEN BEHAVIORAL HEALTHCARE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-28
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1003397878Medicaid