MEDICARE: ADDICTION & MENTAL HEALTH SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	510-8868	OTHER	AL	BLUE CROSS STATE HEALTH PLANS

General Provider Information

NPI Number	:	1750556890
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADDICTION & MENTAL HEALTH SERVICES INC

Provider Business Mailing Address
First Line	:	2101 MAGNOLIA AVE S
Second Line	:	SUITE 518
City	:	BIRMINGHAM
State	:	AL
Zip	:	35205-2827
Country	:	US
Telephone Number	:	205-251-7753
Fax Number	:	205-251-7760

Provider Business Practice Location Address
First Line	:	386 SAINT LUKES DR
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36117-7108
Country	:	US
Telephone Number	:	334-244-0702
Fax Number	:	334-277-2786

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MR. BERNARD B STEPHENS
Credential	:
Telephone Number	:	205-251-7753

Provider Enumeration Date	:	04/29/2008
Last Update Date	:	04/29/2008

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Directions to “ADDICTION & MENTAL HEALTH SERVICES INC ” Practice Location

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