Provider Demographics
NPI:1164202420
Name:IOP BEHAVIORAL HEALTH, LLC
Entity Type:Organization
Organization Name:IOP BEHAVIORAL HEALTH, LLC
Other - Org Name:IOP BEHAVIORAL HEALTH, LLC ALABAMA
Other - Org Type:Other Name
Authorized Official - Title/Position:VP IOP SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:BIRD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-589-1426
Mailing Address - Street 1:4163 E 421 N
Mailing Address - Street 2:
Mailing Address - City:RIGBY
Mailing Address - State:ID
Mailing Address - Zip Code:83442-5516
Mailing Address - Country:US
Mailing Address - Phone:229-589-1426
Mailing Address - Fax:
Practice Address - Street 1:600 SUN TEMPLE DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-8643
Practice Address - Country:US
Practice Address - Phone:229-589-1426
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-04
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty