Provider Demographics
NPI:1508907478
Name:PIEDMONT AREA MH, DD AND SA AUTHORITY
Entity Type:Organization
Organization Name:PIEDMONT AREA MH, DD AND SA AUTHORITY
Other - Org Name:PIEDMONT BEHAVIORAL HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER INFORMATION SYSTEMS
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:704-784-8411
Mailing Address - Street 1:245 LE PHILLIP CT
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-2900
Mailing Address - Country:US
Mailing Address - Phone:704-721-7000
Mailing Address - Fax:704-721-7010
Practice Address - Street 1:245 LE PHILLIP CT
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2900
Practice Address - Country:US
Practice Address - Phone:704-721-7000
Practice Address - Fax:704-721-7010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3404949Medicaid