Organization
MIND OVER MATTER BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID RUSSELL ADAMS CRNP (OWNER/CEO)
(334) 804-6937
Entity
Organization
Contact information
Practice address
131 E COVINGTON AVE, OPP, AL 36467-2122
(334) 804-6937
(716) 265-3348
Mailing address
131 E COVINGTON AVE, OPP, AL 36467-2122
(334) 804-6937
(716) 265-3348
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
08/23/2021
Last updated
08/23/2021
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