Basic Information
| Provider Information | |||||||||
| NPI: | 1922300193 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FOCUS BEHVIORAL HEALTH SERVICES, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 207 QUEEN ST | ||||||||
| Address2: | |||||||||
| City: | MORGANTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286553341 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8284398191 | ||||||||
| FaxNumber: | 8284392622 | ||||||||
| Practice Location | |||||||||
| Address1: | 1140 OLD NC 18 | ||||||||
| Address2: | |||||||||
| City: | MORGANTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286559433 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8284398191 | ||||||||
| FaxNumber: | 8284392622 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/22/2010 | ||||||||
| LastUpdateDate: | 06/29/2021 | ||||||||
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| AuthorizedOfficialLastName: | DOUGLAS | ||||||||
| AuthorizedOfficialFirstName: | PAMELA | ||||||||
| AuthorizedOfficialMiddleName: | JOHNSON | ||||||||
| AuthorizedOfficialTitleorPosition: | PROGRAM DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 8284398191 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | RN | ||||||||
| NPICertificationDate: | 06/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
ID Information
| ID | Type | State | Issuer | Description | MHL012151 | 05 | NC | MEDICAID |