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913 Village Mill Rd Birmingham AL 35215-4331 | |
| (205) 671-4502 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 913 Village Mill Rd, Birmingham, Alabama |
| Authorized Official Name and Position | Vicki Tara Jones (COUNSELOR) |
| Authorized Official Contact | 2056714502 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
404 15th St N Birmingham AL 35203-1845 Ph: (205) 671-4502 | 913 Village Mill Rd Birmingham AL 35215-4331 Ph: (205) 671-4502 |
| NPI Number | 1639627912 |
|---|---|
| Provider Enumeration Date | 09/15/2016 |
| Last Update Date | 10/10/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639627912 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | C2555A (Alabama) | Primary |
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