Healthcare Provider Details

I. General information

NPI: 1962540922
Provider Name (Legal Business Name): BALDWIN COUNTY MENTAL HEALTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 03/23/2010
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: 251-928-0126
Mailing address:
  • Phone: 251-928-2871
  • Fax: 251-928-0126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateAL
# 4
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateAL

VIII. Authorized Official

Name: MR. SIDNEY VINCENT ARBOUR III
Title or Position: ASSOC DIR OF TECH SERVICES
Credential:
Phone: 251-990-4203