Healthcare Provider Details

I. General information

NPI: 1730356676
Provider Name (Legal Business Name): UAB COMPREHENSIVE MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2008
Last Update Date: 05/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

908 20TH STREET SOUTH
BIRMINGHAM AL
35233
US

IV. Provider business mailing address

P O BOX 55310
BIRMINGHAM AL
35255-5310
US

V. Phone/Fax

Practice location:
  • Phone: 205-731-5652
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: REID JONES
Title or Position: EXECUTIVE VP
Credential:
Phone: 205-731-9770