West Tennessee Healthcare Henry County
Organization Active NPI Psychiatric Hospital Unit · Paris, TN
NPI 1699861005 · NPPES record last updated Oct 9, 2024
Key facts
- NPI
- 1699861005
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric Hospital Unit 273R00000X
- License
- 000000057 (TN)
- Legal business name
- WEST TENNESSEE HEALTHCARE HENRY COUNTY
- Practice address
- 301 Tyson Ave
Paris, TN 38242-4544 - Phone
- (731) 642-1220
- Fax
- (731) 644-8587
- NPI assigned
- Oct 4, 2006
- Organization subpart
- No
Authorized official
- Name
- Tina Prescott
- Title
- Interim President and Ceo
- Phone
- (731) 541-6767
Owners & managing parties with NPI records 3
Owned or controlled facilities with NPI records 2
Other NPIs with the same Medicare PAC ID 3
Corporate family (same tax ID) 1
Related certifications (CCN) 1
Facilities with the same owner 2
Practitioners 25
-
Cynthia Lynn Argo, NURSE PRACTITIONER
-
Cary Carter, CRNA
-
Kimberly Elaine Clark, FNP-C
-
Jeremiah Cole, CRNA
-
Andrew Clark Coleman, M.D.
-
Donna Luther Coley, FNP
-
Henry Garcia, CRNA
-
Wendy Hope Greene, CRNA
-
Christopher E Guess, CRNA
-
Terry Olean Harrison, M.D.
-
James Hervey Hudson, M.D.
-
Cynthia Gayle Loines, MSN-CRNA
-
Earl Wade Lomax, CRNA
-
Annie Kathryn Massey, PA-C
-
Meagan Meketi Seratt, DNP, APRN, CRNA
-
Carl William Sisco, CRNA
-
Amber Lynn Stafford, CRNA
-
Vince Charles Tusa, M.D.
-
Thomas A Opilka, CRNA
-
Meredith Tate Richardson, CRNA
-
Kevin Turner, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Hospital certification: CCN 44S132
- Legal name
- WEST TENNESSEE HEALTHCARE HENRY COUNTY
- Doing business as
- HENRY COUNTY LAKE HAVEN BEHAVIORAL HEALTH
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 301 Tyson Ave
Paris, TN 38242-4544 - Hospital subgroups
- Psychiatric unit
All disclosed owners & managing parties 8
| Name | Role | Since | Share |
|---|---|---|---|
| Phil Bryant |
Corporate Director |
Aug 1, 2024 | |
| West Tennessee Healthcare Henry County |
5% Or Greater Direct Ownership Interest | Oct 1, 2024 | 100% |
| Operational/Managerial Control | Oct 1, 2024 | 100% | |
| Jeffrey D Blankenship |
Corporate Officer |
Aug 1, 2024 | |
| W-2 Managing Employee |
Aug 1, 2024 | ||
| Danny Wheeler |
Corporate Director |
Aug 1, 2024 | |
| Charlotte Burch |
Corporate Director |
Aug 1, 2024 | |
| Tina Prescott |
Corporate Officer |
Sep 12, 2024 | |
| W-2 Managing Employee |
Sep 12, 2024 | ||
| Ray Washington |
Corporate Director |
Aug 1, 2024 | |
| Curtis Mansfield |
Corporate Director |
Aug 1, 2024 |
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| West Tennessee Healthcare Henry County Hospital |
Hospital | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Oct 1, 2024 Oct 1, 2024 |
| West Tennessee Medical Group Primary Care Paris Henry County |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Oct 1, 2024 Oct 1, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20241025000975 | TN | Part a Provider - Hospital | 0941731483 | Practice locations: Paris, TN |
National Provider Directory
- Tax ID family
- West Tennessee Healthcare Henry County
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital Unit | 273R00000X | 000000057 | TN | Yes |
Addresses
Primary practice location
301 Tyson Ave
Paris, TN 38242-4544
Mailing address
301 Tyson Avenue
Paris, TN 38242-4544
Phone (731) 642-1220
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 044S132 | Medicaid | TN | |
| 0440132 | Medicaid | TN |
Other names
- Henry County Lake Haven Behavioral Health
Other providers in Paris, TN
- Wellness Ambulatory Care Inc.
- West Tennessee Chiropractic
- West Tennessee Healthcare Henry County
- West Tennessee Healthcare Henry County
- West Tennessee Healthcare Henry County
- West Tennessee Healthcare Henry County
- West Tennessee Healthcare Henry County
- West TN Chiropractic PLLC
- Rodney Scott Whitby
- Robert Whitfield
All providers in Paris, TN · Psychiatric Hospital Unit in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 9, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.