Provider Demographics
NPI:1508677949
Name:HIGHLIGHTS HEALTHCARE OF VIRGINIA, LLC
Entity type:Organization
Organization Name:HIGHLIGHTS HEALTHCARE OF VIRGINIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAHETH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-386-7231
Mailing Address - Street 1:647 BRAWLEY SCHOOL RD STE 104
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-6876
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:411 BRANCHWAY RD STE 211
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-3034
Practice Address - Country:US
Practice Address - Phone:704-703-8588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-15
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health