SOUTHEASTERN PSYCHIATRIC MANAGEMENT INC. NPI 1720131246

NPI Information

  • NPI: 1720131246
  • Provider Name: SOUTHEASTERN PSYCHIATRIC MANAGEMENT, INC.
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Organization
  • Doing Business As: GRANDVIEW BEHAVIORAL HEALTH
  • Address: 315 SAINT LUKES DR
    MONTGOMERY, AL
    ZIP 36117
  • Phone: (334) 409-9242

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NPI Details

SOUTHEASTERN PSYCHIATRIC MANAGEMENT, INC. is a mental health counselor in Montgomery, AL. SOUTHEASTERN PSYCHIATRIC MANAGEMENT, INC. NPI is 1720131246. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Grandview Behavioral Health.

The provider's business location address is:

315 SAINT LUKES DR
MONTGOMERY, AL
ZIP 36117-109
Phone: (334) 409-9242
Fax: (334) 409-9186

The provider's authorized official is Joy R Ballenger .
The authorized official title is Credentialing Network Manager and has the following contact phone number (256) 546-9265.

The enumeration date for this NPI number is 1/19/2007 and was last updated on 3/11/2008.

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 Number License State Primary
1101YM0800XCounselorMental 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
1014730MEDICARE OSCAR/CERTIFICATIONALABAMA

What is NPI?

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This page was last updated on: 3/30/2025

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