Provider Demographics
NPI:1851519557
Name:UNIVERSAL MENTAL HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:UNIVERSAL MENTAL HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:BROOK
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-759-4064
Mailing Address - Street 1:839 WILKESBORO BLVD
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-4612
Mailing Address - Country:US
Mailing Address - Phone:828-759-2228
Mailing Address - Fax:828-759-0159
Practice Address - Street 1:210 NORTHGATE PARK DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-3480
Practice Address - Country:US
Practice Address - Phone:336-896-8188
Practice Address - Fax:336-896-8190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8302028BMedicaid
NC8702085Medicaid
NC6006090Medicaid
NC8302028HMedicaid
NC5906541Medicaid