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1011 S Railroad St Phenix City AL 36867-6220 | |
| (334) 291-6363 | |
| (334) 291-6399 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1011 S Railroad St, Phenix City, Alabama |
| Authorized Official Name and Position | Angelia Cofaye Walton (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3342916363 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1011 S Railroad St Phenix City AL 36867-6220 Ph: (334) 291-6363 | 1011 S Railroad St Phenix City AL 36867-6220 Ph: (334) 291-6363 |
| NPI Number | 1801045117 |
|---|---|
| Provider Enumeration Date | 09/10/2008 |
| Last Update Date | 09/10/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801045117 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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