Provider Demographics
NPI:1235540212
Name:ANDERSON BEHAVIORAL HEALTH, INC
Entity Type:Organization
Organization Name:ANDERSON BEHAVIORAL HEALTH, INC
Other - Org Name:ANDERSON HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:DEMETRIC
Authorized Official - Middle Name:
Authorized Official - Last Name:HAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-624-4620
Mailing Address - Street 1:1915 HASTY RD
Mailing Address - Street 2:
Mailing Address - City:MARSHVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28103-0029
Mailing Address - Country:US
Mailing Address - Phone:704-624-4620
Mailing Address - Fax:704-624-0667
Practice Address - Street 1:1915 HASTY ROAD
Practice Address - Street 2:
Practice Address - City:MARSHVILLE
Practice Address - State:NC
Practice Address - Zip Code:28103-8103
Practice Address - Country:US
Practice Address - Phone:704-290-4246
Practice Address - Fax:704-749-3842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-13
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility