Provider Demographics
NPI:1780705004
Name:HIGH POINT REGIONAL HEALTH SYSTEM
Entity type:Organization
Organization Name:HIGH POINT REGIONAL HEALTH SYSTEM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, BEHAVIORAL HEALTH
Authorized Official - Prefix:MS
Authorized Official - First Name:KITTY
Authorized Official - Middle Name:
Authorized Official - Last Name:STAFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-878-6098
Mailing Address - Street 1:1720 WESTCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7285
Mailing Address - Country:US
Mailing Address - Phone:336-878-6226
Mailing Address - Fax:336-878-6272
Practice Address - Street 1:320 BOULEVARD ST
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-3802
Practice Address - Country:US
Practice Address - Phone:336-878-6226
Practice Address - Fax:336-878-6272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC012MKOtherBCBS OF NC PROVIDER #
NC5901269Medicaid
NC012MKOtherBCBS OF NC PROVIDER #