Provider Demographics
NPI:1346642634
Name:ADDICTION & MENTAL HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:ADDICTION & MENTAL HEALTH SERVICES, LLC
Other - Org Name:BRADFORD HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-244-8112
Mailing Address - Street 1:2101 MAGNOLIA AVE S
Mailing Address - Street 2:SUITE 518
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-2827
Mailing Address - Country:US
Mailing Address - Phone:205-251-7753
Mailing Address - Fax:
Practice Address - Street 1:11215 HERMITAGE RD STE 204
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-3864
Practice Address - Country:US
Practice Address - Phone:501-725-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-18
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder