Organization
NORTHWEST ALABAMA MENTAL HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DALE R COTTLE PH.D. (EXECUTIVE DIRECTOR)
(205) 302-9065
Entity
Organization
Contact information
Practice address
3400 HIGHWAY 78 E, JASPER, AL 35501-8907
(205) 387-4555
(205) 387-4723
Mailing address
3400 HIGHWAY 78 E, JASPER, AL 35501-8907
(205) 387-4555
(205) 387-4723
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
528500930
—
AL
Enumeration date
10/03/2006
Last updated
12/06/2018
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