MEDICARE: ALABAMA DEPARTMENT OF MENTAL HEALTH AND MENTAL RETARDATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982757688
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALABAMA DEPARTMENT OF MENTAL HEALTH AND MENTAL RETARDATION

Provider Business Mailing Address
First Line	:	100 N UNION ST
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36130-0001
Country	:	US
Telephone Number	:	334-242-3107
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 N UNION ST
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36130-0001
Country	:	US
Telephone Number	:	334-242-3107
Fax Number	:

Authorized Official
Title or Position	:	COMMISSIONER
Name	:	JOHN M HOUSTON
Credential	:
Telephone Number	:	334-242-3107

Provider Enumeration Date	:	01/18/2007
Last Update Date	:	08/22/2020

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