Provider Demographics
NPI:1417380395
Name:WINSTON MARION COUNTY ARC
Entity type:Organization
Organization Name:WINSTON MARION COUNTY ARC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIMER
Authorized Official - Suffix:
Authorized Official - Credentials:LBSW LICENSE
Authorized Official - Phone:205-486-2178
Mailing Address - Street 1:145 COUNTY HIGHWAY 76
Mailing Address - Street 2:
Mailing Address - City:HALEYVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35565-3602
Mailing Address - Country:US
Mailing Address - Phone:205-486-2178
Mailing Address - Fax:205-486-6510
Practice Address - Street 1:145 COUNTY HIGHWAY 76
Practice Address - Street 2:
Practice Address - City:HALEYVILLE
Practice Address - State:AL
Practice Address - Zip Code:35565-3602
Practice Address - Country:US
Practice Address - Phone:205-486-2178
Practice Address - Fax:205-486-6510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-15
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health