Provider Demographics
NPI:1609634377
Name:S & S BEHAVIORAL HEALTH, LLC
Entity type:Organization
Organization Name:S & S BEHAVIORAL HEALTH, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SHORT
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:606-389-5269
Mailing Address - Street 1:1907 E PITTSBURG CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40741-9047
Mailing Address - Country:US
Mailing Address - Phone:606-389-5269
Mailing Address - Fax:606-389-5276
Practice Address - Street 1:1907 E PITTSBURG CHURCH RD
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-9047
Practice Address - Country:US
Practice Address - Phone:606-389-5269
Practice Address - Fax:606-389-5276
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:S & S BEHAVIORAL HEALTH, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-03-07
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health