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604 Stone Ave Talladega AL 35160-2217 | |
| (256) 362-8111 | |
| (256) 761-4543 |
| Full Name | |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 604 Stone Ave, Talladega, Alabama |
| Authorized Official Name and Position | Zach Abercrombie (CFO) |
| Authorized Official Contact | 2567614590 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1445 Ross Ave Suite 1400 Dallas TX 75202-2711 Ph: (205) 715-5427 | 604 Stone Ave Talladega AL 35160-2217 Ph: (256) 362-8111 |
| NPI Number | 1881048221 |
|---|---|
| Provider Enumeration Date | 04/22/2016 |
| Last Update Date | 03/22/2022 |
| Certification Date | 03/22/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881048221 | NPI | - | NPPES |
| HOS0101H | Medicaid | AL | |
| 038 | Other | BLUE CROSS | |
| 201000 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |
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