Provider Demographics
NPI:1083762454
Name:ADDICTION & MENTAL HEALTH SERVICES INC
Entity Type:Organization
Organization Name:ADDICTION & MENTAL HEALTH SERVICES INC
Other - Org Name:BRADFORD HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:B
Authorized Official - Last Name:STEPHENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-251-7753
Mailing Address - Street 1:PO BOX 502861
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63150-0001
Mailing Address - Country:US
Mailing Address - Phone:205-251-7753
Mailing Address - Fax:205-251-7760
Practice Address - Street 1:1600 CLINGAN RIDGE DR NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-3652
Practice Address - Country:US
Practice Address - Phone:423-473-0021
Practice Address - Fax:423-473-7694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Not Answered324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility