Provider Demographics
NPI:1760659445
Name:HAWK BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:HAWK BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HUEY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:JR
Authorized Official - Credentials:LCSW
Authorized Official - Phone:314-882-6840
Mailing Address - Street 1:9191 W FLORISSANT AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-1424
Mailing Address - Country:US
Mailing Address - Phone:314-882-6840
Mailing Address - Fax:618-566-8186
Practice Address - Street 1:9191 W FLORISSANT AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-1424
Practice Address - Country:US
Practice Address - Phone:314-882-6840
Practice Address - Fax:618-566-8186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002027247251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health