Healthcare Provider Details

I. General information

NPI: 1316113541
Provider Name (Legal Business Name): BALDWIN COUNTY MENTAL HEALTH CENTER, INC. - ALLKIDS PLUS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2008
Last Update Date: 05/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

372 S GREENO RD
FAIRHOPE AL
36532-1916
US

IV. Provider business mailing address

372 S GREENO RD
FAIRHOPE AL
36532-1916
US

V. Phone/Fax

Practice location:
  • Phone: 251-928-2871
  • Fax:
Mailing address:
  • Phone: 251-928-2871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number StateAL

VIII. Authorized Official

Name: SIDNEY VINCENT ARBOUR III
Title or Position: DIRECTOR OF TECHNICAL SERVICES
Credential:
Phone: 251-990-4203