Healthcare Provider Details

I. General information

NPI: 1235724238
Provider Name (Legal Business Name): MISSION BEHAVIORAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2021
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22270 US HIGHWAY 72 STE B
ATHENS AL
35613-2604
US

IV. Provider business mailing address

3479 COUNTY ROAD 94
FLORENCE AL
35634-4845
US

V. Phone/Fax

Practice location:
  • Phone: 256-795-8143
  • Fax: 256-427-4165
Mailing address:
  • Phone: 256-698-0135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. RICHARD WADE MENEFEE
Title or Position: MANAGING PARTNER
Credential: NP
Phone: 256-278-0569