Healthcare Provider Details

I. General information

NPI: 1447923164
Provider Name (Legal Business Name): SOUTH POINT CONNECTION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2021
Last Update Date: 09/14/2021
Certification Date: 09/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3209 MIDTOWN PARK S
MOBILE AL
36606-4126
US

IV. Provider business mailing address

3209 MIDTOWN PARK S
MOBILE AL
36606-4126
US

V. Phone/Fax

Practice location:
  • Phone: 251-525-9090
  • Fax: 251-525-9091
Mailing address:
  • Phone: 251-525-9090
  • Fax: 251-525-9091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KRYSTLE CURTIN
Title or Position: OFFICE MANAGER
Credential:
Phone: 251-525-9090