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MARSHALL-JACKSON MENTAL HEALTH BD. INC. NPI 1568495588


NPI Information

NPI: 1568495588
Provider Name: MARSHALL-JACKSON MENTAL HEALTH BD., INC.

Doing Business As: MT. LAKES BEHAVIORAL HEALTHCARE

Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
2409 HOMER CLAYTON DR
GUNTERSVILLE, AL
ZIP 35976
Phone: (256) 582-3203
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MARSHALL-JACKSON MENTAL HEALTH BD., INC. is a community behavioral health in Guntersville, AL. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. MARSHALL-JACKSON MENTAL HEALTH BD., INC. NPI is 1568495588. The provider is registered as an organization entity type.
The provider Is Doing Business As Mt. Lakes Behavioral Healthcare.

The provider's business location address is:

2409 HOMER CLAYTON DR
GUNTERSVILLE, AL
ZIP 35976-207
Phone: (256) 582-3203
Fax: (256) 582-3216

The provider's authorized official is Myron Gargis .
The authorized official title is Intermin Executive Director and has the following contact phone number (256) 582-4240.

The enumeration date for this NPI number is 7/10/2006 and was last updated on 10/18/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251S00000XCommunity/Behavioral HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1330000013MEDICAIDALABAMA
2G498MEDICARE ID-TYPE UNSPECIFIEDALABAMAMEDICARE GROUP #
3330034013MEDICAIDALABAMA
41568495588OTHERALABAMAUBH PROVIDER
5=========OTHERALABAMACHAMPUS/TRICARE
6510081221OTHERALABAMABCBS ALLKIDS
7528400680OTHERALABAMAMCR/MCD CROSSOVER GROUP #
8D866MEDICARE ID-TYPE UNSPECIFIEDALABAMAMEDICARE GROUP #
9590000013MEDICAIDALABAMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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