Provider Demographics
NPI:1407882962
Name:ACADIA HOSPITAL OF LONGVIEW, LLC
Entity Type:Organization
Organization Name:ACADIA HOSPITAL OF LONGVIEW, LLC
Other - Org Name:ACADIA PATHWAYS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:NUNEZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:CPA
Authorized Official - Phone:337-264-8121
Mailing Address - Street 1:22 BERMUDA LANE
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-2902
Mailing Address - Country:US
Mailing Address - Phone:903-291-3456
Mailing Address - Fax:337-264-8194
Practice Address - Street 1:22 BERMUDA LANE
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-2902
Practice Address - Country:US
Practice Address - Phone:903-291-3456
Practice Address - Fax:337-264-8194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX178737603Medicaid
TX178737603Medicaid