Healthcare Provider Details

I. General information

NPI: 1033267414
Provider Name (Legal Business Name): ADDICTION & MENTAL HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 W 23RD ST BUILDING D SUITE 29
PANAMA CITY FL
32405-3936
US

IV. Provider business mailing address

2101 MAGNOLIA AVE S SUITE 581
BIRMINGHAM AL
35205-2827
US

V. Phone/Fax

Practice location:
  • Phone: 850-522-5932
  • Fax: 850-522-5959
Mailing address:
  • Phone: 205-251-7753
  • Fax: 205-251-7760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. BERNARAD B STEPHENS
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 205-251-7753