Provider Demographics
NPI:1528376530
Name:KHS HEALTHCARE, INC.
Entity Type:Organization
Organization Name:KHS HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:MHA, CHES
Authorized Official - Phone:910-527-5922
Mailing Address - Street 1:PO BOX 429
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28302-0429
Mailing Address - Country:US
Mailing Address - Phone:910-829-7184
Mailing Address - Fax:910-829-0088
Practice Address - Street 1:226 ROWAN ST
Practice Address - Street 2:B
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28301-4922
Practice Address - Country:US
Practice Address - Phone:910-829-7184
Practice Address - Fax:910-829-0088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-24
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8303328Medicaid