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1428 Temple Ave S Fayette AL 35555-3111 | |
(205) 932-8489 | |
Not Available |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 1428 Temple Ave S, Fayette, Alabama |
Authorized Official Name and Position | Wade Reese (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 2059328489 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1428 Temple Ave S Fayette AL 35555-3111 Ph: () - | 1428 Temple Ave S Fayette AL 35555-3111 Ph: (205) 932-8489 |
NPI Number | 1164602561 |
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Provider Enumeration Date | 11/14/2007 |
Last Update Date | 11/14/2007 |
Identifier | Type | State | Issuer |
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1164602561 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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251S00000X | Community/behavioral Health | (Alabama) | Primary |