Healthcare Provider Details

I. General information

NPI: 1184197493
Provider Name (Legal Business Name): LAUREL OAKS BEHAVIORAL HEALTH CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2019
Last Update Date: 01/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 E COTTONWOOD RD
DOTHAN AL
36301-3644
US

IV. Provider business mailing address

700 E COTTONWOOD RD
DOTHAN AL
36301-3644
US

V. Phone/Fax

Practice location:
  • Phone: 334-794-7373
  • Fax:
Mailing address:
  • Phone: 334-794-7373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: STEVE FILTON
Title or Position: VICE PRESIDENT
Credential:
Phone: 610-768-3482