Organization
JEFFERSON-BLOUNT-ST. CLAIR MH/MR AUTHORITY
Active
Other names
JBS MH/MR Authority
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD CRAIG PH.D. (EXECUTIVE DIRECTOR)
(205) 595-4555
Entity
Organization
Contact information
Practice address
940 MONTCLAIR RD, SUITE 200, BIRMINGHAM, AL 35213-1217
(205) 595-4555
(205) 592-3539
Mailing address
940 MONTCLAIR RD, SUITE 200, BIRMINGHAM, AL 35213-1217
(205) 595-4555
(205) 592-3539
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
AL
251C00000X
Developmentally Disabled Services Day Training Agency
—
AL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
AL
320800000X
Mental Illness Community Based Residential Treatment Facility
—
AL
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008506000
—
AL
05
—
330000017
—
AL
05
—
330034017
—
AL
01
—
51008104
BCBS ALL KIDS BASIC NUMBER
AL
05
—
590000017
—
AL
Enumeration date
09/20/2006
Last updated
06/19/2008
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