Provider Demographics
NPI:1881869345
Name:CALHOUN-CLEBURNE MENTAL HEALTH BOARD INC
Entity type:Organization
Organization Name:CALHOUN-CLEBURNE MENTAL HEALTH BOARD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICKEY
Authorized Official - Middle Name:S
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:256-236-3403
Mailing Address - Street 1:331 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-5731
Mailing Address - Country:US
Mailing Address - Phone:256-236-3403
Mailing Address - Fax:256-238-6263
Practice Address - Street 1:331 E 8TH ST
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-5731
Practice Address - Country:US
Practice Address - Phone:256-236-3403
Practice Address - Fax:256-238-6263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-25
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL8421007OtherALL-KIDS PLUS