Healthcare Provider Details

I. General information

NPI: 1114940830
Provider Name (Legal Business Name): HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

252 SOUTH MAIN STREET
GOODWATER AL
35072
US

IV. Provider business mailing address

PO BOX 70365
MONTGOMERY AL
36107-0365
US

V. Phone/Fax

Practice location:
  • Phone: 256-839-1758
  • Fax: 256-839-6140
Mailing address:
  • Phone: 334-263-2301
  • Fax: 334-264-4353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: CLIFFORD BERNELL MAPP
Title or Position: CEO
Credential:
Phone: 334-263-2301