Organization
PROVIDENCE BEHAVIORAL HEALTH PA
Active
Parent organization
PROVIDENCE BEHAVIORAL HEALTH PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE BEHAVIORAL HEALTH PA
Authorized official
DR. PREETINDER BRAR MD (PRESIDENT)
(704) 543-7574
Entity
Organization
Contact information
Practice address
8029 CORPORATE CENTER DR, SUITE 200, CHARLOTTE, NC 28226-4547
(704) 543-7574
Mailing address
2980 N BEVERLY GLEN CIR, SUITE 301, LOS ANGELES, CA 90077-1726
(310) 474-9809
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
02/03/2012
Last updated
02/03/2012
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