Provider Demographics
NPI:1033612825
Name:BEHAVIORAL HEALTH INTERVENTION CENTER, LLC
Entity type:Organization
Organization Name:BEHAVIORAL HEALTH INTERVENTION CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:LCAS, LMFT
Authorized Official - Phone:704-712-1696
Mailing Address - Street 1:9307 MONROE RD STE P
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28270-1486
Mailing Address - Country:US
Mailing Address - Phone:704-458-9292
Mailing Address - Fax:
Practice Address - Street 1:9307 MONROE RD STE P
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28270-1486
Practice Address - Country:US
Practice Address - Phone:704-458-9292
Practice Address - Fax:704-908-1448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-17
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health