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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