Provider Demographics
NPI:1780859314
Name:MENTAL HEALTH CENTER OF NORTH CENTRAL ALABAMA
Entity Type:Organization
Organization Name:MENTAL HEALTH CENTER OF NORTH CENTRAL ALABAMA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HOOD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:256-260-7324
Mailing Address - Street 1:1316 SOMERVILLE RD SE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-4305
Mailing Address - Country:US
Mailing Address - Phone:256-355-6105
Mailing Address - Fax:
Practice Address - Street 1:4110 HIGHWAY 31 SOUTH
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-4309
Practice Address - Country:US
Practice Address - Phone:256-355-6105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MENTAL HEALTH CENTER OF NORTH CENTRAL ALABAMA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-11695OtherBCBS PROVIDER # FOR PLUS
AL510-08101OtherBCBS PROVIDER # FOR FACILITY