Provider Demographics
NPI:1508097148
Name:SOUTH CENTRAL AL MENTAL HEALTH BOARD
Entity Type:Organization
Organization Name:SOUTH CENTRAL AL MENTAL HEALTH BOARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HR DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BODDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-222-2525
Mailing Address - Street 1:19815 BAY BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:ANDALUSIA
Mailing Address - State:AL
Mailing Address - Zip Code:36420-9234
Mailing Address - Country:US
Mailing Address - Phone:334-222-2525
Mailing Address - Fax:334-222-4660
Practice Address - Street 1:19815 BAY BRANCH RD
Practice Address - Street 2:
Practice Address - City:ANDALUSIA
Practice Address - State:AL
Practice Address - Zip Code:36420-9234
Practice Address - Country:US
Practice Address - Phone:334-222-2525
Practice Address - Fax:334-222-4660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-30
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0894170251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1194866905OtherNPI