JEFFERSON-BLOUNT-ST. CLAIR MH/MR AUTHORITY NPI 1073610499

NPI Information

NPI: 1073610499
Provider Name: JEFFERSON-BLOUNT-ST. CLAIR MH/MR AUTHORITY

Other Name: JBS MH/MR AUTHORITY

Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
940 MONTCLAIR RD
SUITE 200
BIRMINGHAM, AL
ZIP 35213
Phone: (205) 595-4555
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JEFFERSON-BLOUNT-ST. CLAIR MH/MR AUTHORITY is a mental health (including community mental health center) clinic center in Birmingham, AL. JEFFERSON-BLOUNT-ST. CLAIR MH/MR AUTHORITY NPI is 1073610499. The provider is registered as an organization entity type.
The provider Other Name Is Jbs Mh/mr Authority.

The provider's business location address is:

940 MONTCLAIR RD
SUITE 200
BIRMINGHAM, AL
ZIP 35213-217
Phone: (205) 595-4555
Fax: (205) 592-3539

The provider's authorized official is Richard Craig .
The authorized official title is Executive Director and has the following contact phone number (205) 595-4555.

The CLIA number assigned to this NPI record is 01D2232819 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/20/2006 and was last updated on 6/19/2008.

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 State	Primary
1	251B00000X	Case Management		ALABAMA	No
2	251C00000X	Day Training, Developmentally Disabled Services		ALABAMA	No
3	320800000X	Community Based Residential Treatment Facility, Mental Illness		ALABAMA	No
4	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities		ALABAMA	No
5	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	ALABAMA	Yes

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
1	330000017	MEDICAID	ALABAMA
2	590000017	MEDICAID	ALABAMA
3	330034017	MEDICAID	ALABAMA
4	51008104	OTHER	ALABAMA	BCBS ALL KIDS BASIC NUMBER
5	008506000	MEDICAID	ALABAMA

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: 11/14/2023

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