Provider Demographics
NPI:1780197970
Name:G-TEAM, P.C.
Entity Type:Organization
Organization Name:G-TEAM, P.C.
Other - Org Name:SHOALS FAMILY THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:G
Authorized Official - Last Name:GRALL
Authorized Official - Suffix:
Authorized Official - Credentials:MDIV, MA, LPC
Authorized Official - Phone:256-764-3007
Mailing Address - Street 1:218 W ALABAMA ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-5516
Mailing Address - Country:US
Mailing Address - Phone:256-764-3007
Mailing Address - Fax:256-764-9132
Practice Address - Street 1:218 W ALABAMA ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-5516
Practice Address - Country:US
Practice Address - Phone:256-764-3007
Practice Address - Fax:256-764-9132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-09
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Multi-Specialty