| East Central Mental Health Mental Retardation, Inc. | |
|
200 Cherry St Troy AL 36081-2044 | |
| (334) 566-6022 | |
| (334) 566-5346 |
| Full Name | East Central Mental Health Mental Retardation, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 200 Cherry St, Troy, Alabama |
| Authorized Official Name and Position | Malvia G Frye (BUSINESS OFFICE MANAGER) |
| Authorized Official Contact | 3345666022 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| East Central Mental Health Mental Retardation, Inc. 200 Cherry St Troy AL 36081-2044 Ph: (334) 566-6022 | East Central Mental Health Mental Retardation, Inc. 200 Cherry St Troy AL 36081-2044 Ph: (334) 566-6022 |
| NPI Number | 1285717413 |
|---|---|
| Provider Enumeration Date | 10/23/2006 |
| Last Update Date | 06/21/2018 |
| Medicare PECOS PAC ID | 3870575202 |
|---|---|
| Medicare Enrollment ID | O20040601001053 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285717413 | NPI | - | NPPES |
| 51022653 | Other | AL | BCBS DR. |
| 8401000 | Medicaid | AL | |
| 6231195 | Other | AL | UBH |
| 6232119 | Other | AL | UBH |
| 510-08117 | Other | AL | BCBS PPO PLANS |
| 6242119 | Other | AL | UBH |
| 6342119 | Other | AL | UBH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Saeed A Shah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700831344 PECOS PAC ID: 7214910439 Enrollment ID: I20040609001006 |
| Provider Name | Mahija Mungara |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245454487 PECOS PAC ID: 1951315381 Enrollment ID: I20080206000411 |
| Provider Name | Stephanie P Reese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457741431 PECOS PAC ID: 2062730542 Enrollment ID: I20150413001946 |
| Provider Name | Shawn Rene Howard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477950350 PECOS PAC ID: 3476825290 Enrollment ID: I20170814002663 |
| Provider Name | Kerri Lyn Outlaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740821958 PECOS PAC ID: 9234049776 Enrollment ID: I20200318002506 |
| Provider Name | Kamesha Dees Moultry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649727850 PECOS PAC ID: 1557766086 Enrollment ID: I20210823000872 |
| Provider Name | Kimberly R Miles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811602469 PECOS PAC ID: 6608241518 Enrollment ID: I20230406001980 |
East Central Mental Health Mental Retardation, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Cherry St, Troy, AL 36081 Phone: 334-566-6022 Fax: 334-566-5346 | |
Warren Behavioral Care, Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 889 Elba Hwy, Troy, AL 36079 Phone: 334-808-8991 Fax: 334-808-8995 | |
East Central Mental Health Mental Retardation, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Cherry St, Troy, AL 36081 Phone: 334-566-6022 Fax: 334-566-5346 | |
East Central Mental Health Mental Retardation, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Cherry St, Troy, AL 36081 Phone: 334-566-6022 Fax: 334-566-5346 | |
East Central Mental Health Mental Retardation, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Cherry St, Troy, AL 36081 Phone: 334-566-6022 Fax: 334-566-5346 | |
Troy Resilience Project Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 401 S Brundidge St, Troy, AL 36081 Phone: 334-770-0928 |