NPIMap

Organization Active NPI

Behavioral Health Center-Mercy Horizons Op Services

  • Adult Mental Health Clinic/Center
  • Charlotte, NC
National Provider Identifier
1265612014
Registry record updated Nov 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
MHL-060-577 Issued in NC
Legal business name
BEHAVIORAL HEALTH CENTER-MERCY HORIZONS OP SERVICES
Practice address
1816 Lyndhurst Avenue
Behavioral Heatlh Center Mercy Horizons Outpatient SVCS
Charlotte, NC 28203-5104
Phone
(704) 446-0392
Fax
(704) 348-4057
NPI assigned
Nov 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Thomas E. Gettelman, PHD
Title
Assistant Vice President
Phone
(704) 444-2406

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X MHL-060-577 NC Primary

Addresses

Primary practice location

1816 Lyndhurst Avenue
Behavioral Heatlh Center Mercy Horizons Outpatient SVCS
Charlotte, NC 28203-5104

Mailing address

501 Billingsley Road
Behavioral Health Center CMC Randolph
Charlotte, NC 28211-1009
Phone (704) 358-2710

Other identifiers 1

IdentifierTypeStateIssuer
8300444PMedicaidNC

Other names 1

  • SA Comprehensive OP Treatment Program Other name

National Provider Directory

National Provider Directory
Tax ID family
Behavioral Health Center-Mercy Horizons Op Services4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1194566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194566400000",
    "number": "1265612014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 BILLINGSLEY ROAD",
            "address_2": "BEHAVIORAL HEALTH CENTER CMC RANDOLPH",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111009",
            "telephone_number": "704-358-2710",
            "fax_number": "704-358-2938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1816 LYNDHURST AVENUE",
            "address_2": "BEHAVIORAL HEATLH CENTER MERCY HORIZONS OUTPATIENT SVCS",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035104",
            "telephone_number": "704-446-0392",
            "fax_number": "704-348-4057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEHAVIORAL HEALTH CENTER-MERCY HORIZONS OP SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-09",
        "last_updated": "2007-11-09",
        "status": "A",
        "authorized_official_last_name": "GETTELMAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "ASSISTANT VICE PRESIDENT",
        "authorized_official_telephone_number": "704-444-2406",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NC",
            "license": "MHL-060-577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300444P",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SA Comprehensive OP Treatment Program",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.