Provider Demographics
NPI:1629819248
Name:BEHAVIORAL HEALTH REIMAGINED LLC
Entity type:Organization
Organization Name:BEHAVIORAL HEALTH REIMAGINED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KARLI
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:205-358-7686
Mailing Address - Street 1:230 BEARDEN RD
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-1715
Mailing Address - Country:US
Mailing Address - Phone:205-358-7686
Mailing Address - Fax:877-940-3057
Practice Address - Street 1:230 BEARDEN RD
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-1715
Practice Address - Country:US
Practice Address - Phone:205-358-7686
Practice Address - Fax:877-940-3057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty