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WIREGRASS MENTAL HEALTH BOARD INC NPI 1568638534


NPI Information

NPI: 1568638534
Provider Name: WIREGRASS MENTAL HEALTH BOARD INC

Doing Business As: SPECTRACARE

Classification: Clinic/Center - 261QM0855X
Entity Type: Organization

Specialization: Adolescent and Children Mental Health

Address:
134 PREVATT RD
DOTHAN, AL
ZIP 36301
Phone: (334) 794-0731
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WIREGRASS MENTAL HEALTH BOARD INC is an adolescent and children mental health clinic center in Dothan, AL. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. WIREGRASS MENTAL HEALTH BOARD INC NPI is 1568638534. The provider is registered as an organization entity type.
The provider Is Doing Business As Spectracare.

The provider's business location address is:

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

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 4/30/2008 and was last updated on 4/30/2008.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)No
2261QM0855XClinic/CenterAdolescent and Children Mental 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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1591600003MEDICAIDALABAMA
2000008817OTHERALABAMAMEDICARE
3331000067MEDICAIDALABAMA
433034010MEDICAIDALABAMA
5331000467MEDICAIDALABAMA
6330034010MEDICAIDALABAMA
7331000069MEDICAIDALABAMA
833000067MEDICAIDALABAMA
9330000010MEDICAIDALABAMA
1014635OTHERALABAMAMEDICARE SECONDARY
11331600587MEDICAIDALABAMA
12591500003MEDICAIDALABAMA
13059726100MEDICAIDFLORIDA
1451043902OTHERALABAMABLUE CROSS BLUE SHIELD
15331600592MEDICAIDALABAMA
16590000010MEDICAIDALABAMA
1714609OTHERALABAMAMEDICARE SECONDARY
1851003550OTHERALABAMACOMMERCIAL INS.
1920427OTHERALABAMAMEDICARESECONDARY

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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