Provider Demographics
NPI:1134801483
Name:ALTON BEHAVIORAL HEALTH MANAGEMENT
Entity type:Organization
Organization Name:ALTON BEHAVIORAL HEALTH MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FEMI
Authorized Official - Middle Name:
Authorized Official - Last Name:FOLORUNSHO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:901-399-0383
Mailing Address - Street 1:3900 NEW COVINGTON PIKE STE 107
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38128-2526
Mailing Address - Country:US
Mailing Address - Phone:901-877-5641
Mailing Address - Fax:877-471-2552
Practice Address - Street 1:3900 NEW COVINGTON PIKE STE 107
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128-2526
Practice Address - Country:US
Practice Address - Phone:901-399-0383
Practice Address - Fax:877-471-2552
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALTON BEHAVIORAL HEALTH MANAGEMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No251K00000XAgenciesPublic Health or Welfare
No253Z00000XAgenciesIn Home Supportive Care
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No283X00000XHospitalsRehabilitation Hospital