Healthcare Provider Details

I. General information

NPI: 1487702866
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: 04/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 ROSSMORE PL
AUGUSTA GA
30909-5769
US

IV. Provider business mailing address

PO BOX 830585
BIRMINGHAM AL
35283-0585
US

V. Phone/Fax

Practice location:
  • Phone: 706-854-1126
  • Fax: 706-855-1790
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. BERNARD B STEPHENS
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 205-251-7753