Provider Demographics
NPI:1063560415
Name:ADDICTION & MENTAL HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:ADDICTION & MENTAL HEALTH SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-244-8112
Mailing Address - Street 1:2101 MAGNOLIA AVE S STE 518
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-2853
Mailing Address - Country:US
Mailing Address - Phone:205-251-7753
Mailing Address - Fax:205-251-7760
Practice Address - Street 1:515 ENERGY CENTER BLVD
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35473-2797
Practice Address - Country:US
Practice Address - Phone:205-752-1395
Practice Address - Fax:205-758-0571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder