Provider Demographics
NPI:1114940830
Name:HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:HEALTH SERVICES, INC.
Other - Org Name:GOODWATER FAMILY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CLIFFORD
Authorized Official - Middle Name:BERNELL
Authorized Official - Last Name:MAPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-263-2301
Mailing Address - Street 1:PO BOX 70365
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36107-0365
Mailing Address - Country:US
Mailing Address - Phone:334-263-2301
Mailing Address - Fax:334-264-4353
Practice Address - Street 1:252 SOUTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:GOODWATER
Practice Address - State:AL
Practice Address - Zip Code:35072
Practice Address - Country:US
Practice Address - Phone:256-839-1758
Practice Address - Fax:256-839-6140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)