Healthcare Provider Details

I. General information

NPI: 1417779406
Provider Name (Legal Business Name): SIMA CAN HELP ALABAMA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2024
Last Update Date: 10/30/2024
Certification Date: 10/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PERIMETER PARK S STE 100N
BIRMINGHAM AL
35243-3248
US

IV. Provider business mailing address

1755 N BROWN RD STE 200
LAWRENCEVILLE GA
30043-2018
US

V. Phone/Fax

Practice location:
  • Phone: 347-833-0428
  • Fax:
Mailing address:
  • Phone: 347-833-0428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SIMA MUJENYI
Title or Position: CEO
Credential: LCSW
Phone: 347-833-0428