Provider Demographics
NPI:1659650281
Name:AURORA BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:AURORA BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:MIDKIFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-840-8553
Mailing Address - Street 1:505 STATE ST
Mailing Address - Street 2:
Mailing Address - City:PROCTORVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45669-3099
Mailing Address - Country:US
Mailing Address - Phone:740-451-1011
Mailing Address - Fax:740-451-1109
Practice Address - Street 1:505 STATE ST
Practice Address - Street 2:
Practice Address - City:PROCTORVILLE
Practice Address - State:OH
Practice Address - Zip Code:45669-3099
Practice Address - Country:US
Practice Address - Phone:740-451-1011
Practice Address - Fax:740-451-1109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-14
Last Update Date:2011-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health