Provider Demographics
NPI:1962055699
Name:ALABAMA DEPARTMENT OF MENTAL HEALTH
Entity type:Organization
Organization Name:ALABAMA DEPARTMENT OF MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CIO
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-242-3315
Mailing Address - Street 1:PO BOX 301410
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36130-1410
Mailing Address - Country:US
Mailing Address - Phone:334-242-3315
Mailing Address - Fax:
Practice Address - Street 1:100 N UNION ST # 468
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36104-3719
Practice Address - Country:US
Practice Address - Phone:334-242-3315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-22
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation