| Tricare Behavorial Health Llc | |
|
4024 Fort Henry Dr Kingsport TN 37663-2028 | |
| (423) 239-4638 | |
| (423) 239-5249 |
| Full Name | Tricare Behavorial Health Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4024 Fort Henry Dr, Kingsport, Tennessee |
| Authorized Official Name and Position | Lowell Bruce Mckee (CEO) |
| Authorized Official Contact | 4232392190 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tricare Behavorial Health Llc 4024 Fort Henry Dr Kingsport TN 37663-2028 Ph: (423) 239-4638 | Tricare Behavorial Health Llc 4024 Fort Henry Dr Kingsport TN 37663-2028 Ph: (423) 239-4638 |
| NPI Number | 1891844973 |
|---|---|
| Provider Enumeration Date | 01/09/2007 |
| Last Update Date | 02/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891844973 | NPI | - | NPPES |
| L 2(14)M2-106-1633 | Other | TN | TRICARE BRISTOL LICENSE |
| L 2(14)M2-106-1632 | Other | TN | STRESS CARE ASSOC LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | L 2(14)M2-106-1633 (Tennessee) | Secondary |
| 251S00000X | Community/behavioral Health | L 2(14)M2-106-1632 (Tennessee) | Primary |
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