| Glenwood | |
|
2361 Fairlane Dr Montgomery AL 36116-1633 | |
| (334) 262-5744 | |
| (334) 262-5155 |
| Full Name | Glenwood |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2361 Fairlane Dr, Montgomery, Alabama |
| Authorized Official Name and Position | D Lee Yount (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2057953210 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Glenwood 2361 Fairlane Dr Montgomery AL 36116-1633 Ph: (334) 262-5744 | Glenwood 2361 Fairlane Dr Montgomery AL 36116-1633 Ph: (334) 262-5744 |
| NPI Number | 1225079262 |
|---|---|
| Provider Enumeration Date | 06/09/2006 |
| Last Update Date | 02/15/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225079262 | NPI | - | NPPES |
| 529925380 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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