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SPECTRACARE HEALTH SYSTEMS INC. NPI 1215990734


NPI Information

NPI: 1215990734
Provider Name: SPECTRACARE HEALTH SYSTEMS, INC.

Former Legal Business Name: WIREGRASS MENTAL HEALTH BOARD, INC.

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

Specialization: Mental Health (Including Community Mental Health Center)

Address:
134 PREVATT RD
DOTHAN, AL
ZIP 36301
Phone: (334) 794-0731
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SPECTRACARE HEALTH SYSTEMS, INC. is a mental health (including community mental health center) clinic center in Dothan, AL. SPECTRACARE HEALTH SYSTEMS, INC. NPI is 1215990734. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Wiregrass Mental Health Board, Inc..

The provider's business location address is:

134 PREVATT RD
DOTHAN, AL
ZIP 36301-427
Phone: (334) 794-0731
Fax: (334) 671-9199

The provider's authorized official is Melissa Kirkland .
The authorized official title is Executive Director and has the following contact phone number (334) 712-2720.

The enumeration date for this NPI number is 4/7/2006 and was last updated on 11/28/2012.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1320600000XResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesNo
2324500000XSubstance Abuse Rehabilitation FacilityNo
3261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
151003550OTHERALABAMACOMMERCIAL INSURANCE
233000010MEDICAIDALABAMA
320427MEDICARE ID-TYPE UNSPECIFIEDALABAMAMEDICARE SECONDARY
4331000067MEDICAIDALABAMA
5014609MEDICARE ID-TYPE UNSPECIFIEDALABAMAMEDICARE SECONDARY
6331000467MEDICAIDALABAMA
7008301620MEDICAIDALABAMA
8059726100MEDICAIDFLORIDA
951043903OTHERALABAMABLUE CROSS BLUE SHIELD
10008412000MEDICAIDALABAMA
11330000010MEDICAIDALABAMA
12331000069MEDICAIDALABAMA
13590000010MEDICAIDALABAMA
14014635MEDICARE ID-TYPE UNSPECIFIEDALABAMAMEDICARE SECONDARY
15330034010MEDICAIDALABAMA
16331600592MEDICAIDALABAMA
17591500003MEDICAIDALABAMA
18591600003MEDICAIDALABAMA
19000008817MEDICARE ID-TYPE UNSPECIFIEDALABAMAMEDICARE PHYSICIANS PART
20331600587MEDICAIDALABAMA

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: 4/28/2024

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