Provider Demographics
NPI:1093325557
Name:HIGHLAND BEHAVIORAL HEALTHCARE
Entity Type:Organization
Organization Name:HIGHLAND BEHAVIORAL HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:R
Authorized Official - Last Name:OLSEN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:931-250-5488
Mailing Address - Street 1:2018 HIGHLAND LN
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38555-1467
Mailing Address - Country:US
Mailing Address - Phone:931-250-5488
Mailing Address - Fax:
Practice Address - Street 1:29 TAYLOR AVE STE 204
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-4537
Practice Address - Country:US
Practice Address - Phone:931-250-5488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-08
Last Update Date:2020-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty