| Caroline Abolade | |
|
8439 Crossland Loop Montgomery AL 36117-8485 | |
| (334) 409-9242 | |
| (334) 409-9186 |
| Full Name | Caroline Abolade |
|---|---|
| Speciality | Clinic/Center |
| Location | 8439 Crossland Loop, Montgomery, Alabama |
| Authorized Official Name and Position | Caroline Abolade (MEDICAL DIRECTOR/CEO) |
| Authorized Official Contact | 3342240020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Caroline Abolade 8439 Crossland Loop Montgomery AL 36117-8485 Ph: (334) 409-9242 | Caroline Abolade 8439 Crossland Loop Montgomery AL 36117-8485 Ph: (334) 409-9242 |
| NPI Number | 1720404619 |
|---|---|
| Provider Enumeration Date | 03/15/2014 |
| Last Update Date | 06/05/2014 |
| Medicare PECOS PAC ID | 8325268964 |
|---|---|
| Medicare Enrollment ID | O20141003000161 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720404619 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 26027 (Alabama) | Primary |
| Provider Name | Caroline O Abolade |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528002128 PECOS PAC ID: 3476454372 Enrollment ID: I20051207000388 |
| Provider Name | Patricia Randich-dumas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427140292 PECOS PAC ID: 7517068976 Enrollment ID: I20070730000239 |
| Provider Name | Vonceil Smith |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1811985690 PECOS PAC ID: 4183817984 Enrollment ID: I20101026000105 |
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