Provider Demographics
NPI:1801411905
Name:SUMMIT BHC WEST VIRGINIA, LLC
Entity Type:Organization
Organization Name:SUMMIT BHC WEST VIRGINIA, LLC
Other - Org Name:HIGHLAND PHYSICIANS GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF LEGAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-716-4924
Mailing Address - Street 1:389 NICHOL MILL LN
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-4882
Mailing Address - Country:US
Mailing Address - Phone:877-463-3553
Mailing Address - Fax:615-435-3725
Practice Address - Street 1:300 56TH ST SE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-2308
Practice Address - Country:US
Practice Address - Phone:304-926-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-15
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty