Provider Demographics
NPI:1861260788
Name:PAINTSVILLE BEHAVIORAL HEALTH, INC
Entity type:Organization
Organization Name:PAINTSVILLE BEHAVIORAL HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:CRASE
Authorized Official - Suffix:
Authorized Official - Credentials:DSW, LCSW
Authorized Official - Phone:606-226-1530
Mailing Address - Street 1:1841 PEARTREE LN
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-4460
Mailing Address - Country:US
Mailing Address - Phone:606-226-1530
Mailing Address - Fax:
Practice Address - Street 1:1841 PEARTREE LN
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-4460
Practice Address - Country:US
Practice Address - Phone:606-226-1530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PAINTSVILLE BEHAVIORAL HEALTH, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-20
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty