Provider Demographics
NPI:1184168395
Name:PIEDMONT HEALTH PARTNERS
Entity type:Organization
Organization Name:PIEDMONT HEALTH PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NAKITA
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:SYDNOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-710-9415
Mailing Address - Street 1:142 BLAIR PL
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24540-2840
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:142 BLAIR PL
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-2840
Practice Address - Country:US
Practice Address - Phone:434-710-9415
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-06
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health