Provider Demographics
NPI:1720393416
Name:CALHOUN-CLEBURNE MENTAL HEALTH BOARD
Entity Type:Organization
Organization Name:CALHOUN-CLEBURNE MENTAL HEALTH BOARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICKEY
Authorized Official - Middle Name:S
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-236-3043
Mailing Address - Street 1:150 TOMPKINS ST
Mailing Address - Street 2:
Mailing Address - City:HEFLIN
Mailing Address - State:AL
Mailing Address - Zip Code:36264-1836
Mailing Address - Country:US
Mailing Address - Phone:256-463-2969
Mailing Address - Fax:256-463-5472
Practice Address - Street 1:150 TOMPKINS ST
Practice Address - Street 2:
Practice Address - City:HEFLIN
Practice Address - State:AL
Practice Address - Zip Code:36264-1836
Practice Address - Country:US
Practice Address - Phone:256-463-2969
Practice Address - Fax:256-463-5472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-18
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1942C251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health