Provider Demographics
NPI:1982850376
Name:ADDICTION & MENTAL HEALTH SERVICES INC
Entity Type:Organization
Organization Name:ADDICTION & MENTAL HEALTH SERVICES INC
Other - Org Name:BRADFORD HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:B
Authorized Official - Last Name:STEPHENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-251-7753
Mailing Address - Street 1:2101 MAGNOLIA AVE S
Mailing Address - Street 2:SUITE 518
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-2827
Mailing Address - Country:US
Mailing Address - Phone:205-251-7753
Mailing Address - Fax:205-251-7760
Practice Address - Street 1:860 BROOKSTONE CENTRE PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-9270
Practice Address - Country:US
Practice Address - Phone:706-649-3075
Practice Address - Fax:706-649-6709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL600-39176OtherBLUE CROSS OF ALABAMA- SEIB & ALLKIDS