Provider Demographics
NPI:1639362411
Name:DAYMARK PASTORAL COUNSELING
Entity Type:Organization
Organization Name:DAYMARK PASTORAL COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:
Authorized Official - Last Name:BALS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-871-3332
Mailing Address - Street 1:PO BOX 59768
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35259-9768
Mailing Address - Country:US
Mailing Address - Phone:205-871-3332
Mailing Address - Fax:
Practice Address - Street 1:402 OFFICE PARK DR
Practice Address - Street 2:SUITE 220
Practice Address - City:MOUNTAIN BROOK
Practice Address - State:AL
Practice Address - Zip Code:35223-2417
Practice Address - Country:US
Practice Address - Phone:205-871-3332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-24
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Single Specialty