Basic Information
Provider Information
NPI: 1578832549
EntityType: 2
ReplacementNPI:  
OrganizationName: FOCUS BEHAVIORAL HEALTH SERVICES, LLC
LastName:  
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Credential:  
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Mailing Information
Address1: PO BOX 3624
Address2:  
City: MORGANTON
State: NC
PostalCode: 286803624
CountryCode: US
TelephoneNumber: 8284398191
FaxNumber: 8284392588
Practice Location
Address1: 145 CEDAR VALLEY RD
Address2:  
City: HUDSON
State: NC
PostalCode: 286382511
CountryCode: US
TelephoneNumber: 8287283538
FaxNumber: 8287283539
Other Information
ProviderEnumerationDate: 12/21/2011
LastUpdateDate: 11/26/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: DOUGLAS
AuthorizedOfficialFirstName: PAMELA
AuthorizedOfficialMiddleName: J
AuthorizedOfficialTitleorPosition: DIRECTOR
AuthorizedOfficialTelephone: 8284398191
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MRS.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: RN
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251S00000X  Y AgenciesCommunity/Behavioral Health 

ID Information
IDTypeStateIssuerDescription
01408005NC MEDICAID


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