Provider Demographics
NPI:1740294610
Name:HIGHLAND BEHAVIORAL HEALTH SVCS
Entity type:Organization
Organization Name:HIGHLAND BEHAVIORAL HEALTH SVCS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RISK MANAGEMENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-926-1600
Mailing Address - Street 1:14 PRESIDIO POINTE
Mailing Address - Street 2:
Mailing Address - City:CROSS LANES
Mailing Address - State:WV
Mailing Address - Zip Code:25313-1537
Mailing Address - Country:US
Mailing Address - Phone:304-369-1930
Mailing Address - Fax:
Practice Address - Street 1:2 HUMAN SERVICE COMPLEX
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:WV
Practice Address - Zip Code:25053-9678
Practice Address - Country:US
Practice Address - Phone:304-369-1930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV21257103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3004199000Medicaid
WVPA 411 2462Medicare ID - Type Unspecified
H89431Medicare UPIN