| Southern Highlands Community Mental Health Center, Inc. | |
|
200 12th Street Ext Princeton WV 24740-2329 | |
| (304) 425-9541 | |
| (681) 282-5558 |
| Full Name | Southern Highlands Community Mental Health Center, Inc. |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 200 12th Street Ext, Princeton, West Virginia |
| Authorized Official Name and Position | Lisa L. Jones (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3044259541 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Highlands Community Mental Health Center, Inc. 200 12th Street Ext Princeton WV 24740-2329 Ph: (304) 425-9541 | Southern Highlands Community Mental Health Center, Inc. 200 12th Street Ext Princeton WV 24740-2329 Ph: (304) 425-9541 |
| NPI Number | 1205476488 |
|---|---|
| Provider Enumeration Date | 01/15/2020 |
| Last Update Date | 01/15/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205476488 | NPI | - | NPPES |
| 0005489001 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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