Organization
MENTAL HEALTH BD OF BIBB PICKENS AND TUSCALOOSA COUNTIES
Active
Other names
Indian Rivers MHC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BLAKE THRASHER (CFO)
(205) 391-3131
Entity
Organization
Contact information
Practice address
2209 9TH ST, TUSCALOOSA, AL 35401-2300
(205) 391-3131
(205) 391-3137
Mailing address
PO BOX 2190, 2209 9TH STREET, TUSCALOOSA, AL 35403-2190
(205) 391-3131
(205) 391-3137
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
330000024
—
AL
05
—
330034024
—
AL
01
—
51008111
BCBS OF AL
AL
05
—
528700510
—
AL
05
—
590000024
—
AL
Enumeration date
06/10/2006
Last updated
01/23/2012
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