Organization
EASTSIDE MENTAL HEALTH CENTER INC
Active
Parent organization
EASTSIDE MENTAL HEALTH CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
EASTSIDE MENTAL HEALTH CENTER
Authorized official
MRS. BEVERLY FRANCES LCSW (EXECUTIVE DIRECTOR)
(205) 836-7283
Entity
Organization
Contact information
Practice address
129 E PARK CIR, BIRMINGHAM, AL 35235-3000
(205) 836-7283
(205) 836-9594
Mailing address
129 E PARK CIR, BIRMINGHAM, AL 35235-3000
(205) 836-7283
(205) 836-9594
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051008105
PEEHIP STATE INSURANCE
AL
05
—
330000004
—
AL
01
—
I023
MEDICARE GROUP BLOUNT
AL
Enumeration date
01/23/2007
Last updated
01/27/2020
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