Provider Demographics
NPI:1851485981
Name:NORTHWEST ALABAMA MENTAL HEALTH CENTER
Entity Type:Organization
Organization Name:NORTHWEST ALABAMA MENTAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FLOYD
Authorized Official - Middle Name:FULTON
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:205-302-9065
Mailing Address - Street 1:5980 HIGHWAY 159
Mailing Address - Street 2:
Mailing Address - City:FAYETTE
Mailing Address - State:AL
Mailing Address - Zip Code:35555-5047
Mailing Address - Country:US
Mailing Address - Phone:205-932-8769
Mailing Address - Fax:205-904-8709
Practice Address - Street 1:5980 HIGHWAY 159
Practice Address - Street 2:
Practice Address - City:FAYETTE
Practice Address - State:AL
Practice Address - Zip Code:35555-5047
Practice Address - Country:US
Practice Address - Phone:205-932-8769
Practice Address - Fax:205-904-8709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
014669Medicare ID - Type Unspecified