Healthcare Provider Details

I. General information

NPI: 1831970193
Provider Name (Legal Business Name): IOP BEHAVIORAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2023
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 SUN TEMPLE DR
MADISON AL
35758-8643
US

IV. Provider business mailing address

350 SUN TEMPLE DR
MADISON AL
35758-5919
US

V. Phone/Fax

Practice location:
  • Phone: 229-259-1426
  • Fax:
Mailing address:
  • Phone: 256-693-5301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CATHERINE PETERSON
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 256-975-4291