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General NPI Number Information
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NPI Number | 1760284814
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Entity Type | Organization
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Legal Business Name | BAYVIEW WELLNESS, LLC
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Dates
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Enumeration Date | 03/26/2025
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 300 STATE ST
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City | MOBILE
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State | AL
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Zip | 36603-6425
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Country | US
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Telephone | 251-234-3003
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Fax |
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Provider Business Mailing Address
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Address Line | 358 SAINT LOUIS ST
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City | MOBILE
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State | AL
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Zip | 36602-2825
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | EJEMHEN HINES
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Credential | LPC
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Telephone | 251-234-3003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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