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Organization
SPECTRACARE HEALTH SYSTEMS, INC.
Active
Organization
SPECTRACARE HEALTH SYSTEMS, INC.
Active
Other names
Wiregrass Mental Health Board, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MELISSA KIRKLAND (EXECUTIVE DIRECTOR)
(334) 712-2720
Entity
Organization
Contact information
Practice address
134 PREVATT RD, DOTHAN, AL 36301-5427
(334) 794-0731
(334) 671-9199
Mailing address
PO BOX 1245, 2694 SOUTH PARK AVE., DOTHAN, AL 36302-1245
(334) 712-2720
(334) 712-2727
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008301620
—
AL
05
—
008412000
—
AL
05
—
059726100
—
FL
05
—
330000010
—
AL
05
—
33000010
—
AL
05
—
330034010
—
AL
05
—
331000067
—
AL
05
—
331000069
—
AL
05
—
331000467
—
AL
05
—
331600587
—
AL
05
—
331600592
—
AL
01
—
51003550
COMMERCIAL INSURANCE
AL
01
—
51043903
BLUE CROSS BLUE SHIELD
AL
05
—
590000010
—
AL
05
—
591500003
—
AL
05
—
591600003
—
AL
Enumeration date
04/07/2006
Last updated
11/28/2012
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