Healthcare Provider Details

I. General information

NPI: 1043014996
Provider Name (Legal Business Name): HANOVER BEHAVIORAL PARTNERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2025
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 HANOVER CIR S
BIRMINGHAM AL
35205-1703
US

IV. Provider business mailing address

39 HANOVER CIR S
BIRMINGHAM AL
35205-1703
US

V. Phone/Fax

Practice location:
  • Phone: 205-877-8677
  • Fax:
Mailing address:
  • Phone: 850-377-9712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: KAREN MUSGROVE
Title or Position: CEO
Credential: PHD, MED,LPC
Phone: 205-322-4197