Organization
VCPHCS XVII, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAY HIGHAM (CEO)
(214) 365-6112
Entity
Organization
Contact information
Practice address
1202 S JAMES CAMPBELL BLVD, SUITE 7A, COLUMBIA, TN 38401-5193
(931) 381-0020
(931) 381-0029
Mailing address
5001 SPRING VALLEY ROAD, SUITE 600 EAST, DALLAS, TX 75244-3946
(214) 365-6100
(214) 365-6150
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM2800X
Methadone Clinic
L000000012587
TN
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
05/16/2013
Last updated
12/26/2024
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