WIREGRASS MENTAL HEALTH BOARD INC (NPI# 1568638534) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568638534 |
| Entity Type | Organization |
| Organization Name | WIREGRASS MENTAL HEALTH BOARD INC |
| Other Organization Name | SPECTRACARE |
| Practice Address |
134 Prevatt Rd Dothan AL 36301-5427 |
| Mailing Address |
Po Box 1245 2694 South Park Ave. Dothan AL 36302-1245 |
| Practice Telephone | 3347940731 |
| Mailing Telephone | 3347122720 |
| Mailing Fax Number | 3347122727 |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2008-04-30 |
| Authorized Official Name | MRS. MELISSA KIRKLAND (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3347122720 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 33034010 | 05 | |
| AL | 331600587 | 05 | |
| AL | MEDICARE SECONDARY | 14609 | 01 |
| AL | MEDICARESECONDARY | 20427 | 01 |
| AL | 591500003 | 05 | |
| AL | MEDICARE | 000008817 | 01 |
| AL | MEDICARE SECONDARY | 14635 | 01 |
| AL | BLUE CROSS BLUE SHIELD | 51043902 | 01 |
| AL | 591600003 | 05 | |
| FL | 059726100 | 05 | |
| AL | 331000467 | 05 | |
| AL | 33000067 | 05 | |
| AL | 331000069 | 05 | |
| AL | 331600592 | 05 | |
| AL | 590000010 | 05 | |
| AL | 330000010 | 05 | |
| AL | COMMERCIAL INS. | 51003550 | 01 |
| AL | 330034010 | 05 | |
| AL | 331000067 | 05 |
| Other Name | Type Code |
|---|---|
| SpectraCare | Doing Business As Name - Organization |
| Street Address |
134 PREVATT RD |
| City | DOTHAN |
| State | AL |
| Zip Code | 36301-5427 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215990734 | Spectracare Health Systems, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 134 Prevatt Rd, Dothan, AL 36301-5427 | 2006-04-07 |
| 1386024560 | Genoa Healthcare, LLC | Pharmacy | 134 Prevatt Rd, Dothan, AL 36301-5427 | 2015-06-03 |
| 1720477623 | Kelli Vickers | Counselor | 134 Prevatt Rd, Dothan, AL 36301-5427 | 2015-01-15 |
| 1992115133 | Christina Hussey | Social Worker | 134 Prevatt Rd, Dothan, AL 36301-5427 | 2014-04-28 |
| 1760808042 | Tarama Lashay Fleming | Counselor | 134 Prevatt Rd, Dothan, AL 36301-5427 | 2014-03-11 |
| 1790083400 | Northeast Pharmaceuticals Inc | Pharmacy | 134 Prevatt Rd, Dothan, AL 36301-5427 | 2011-03-03 |
| 1184956872 | Richard Reginald Brookins | Counselor | 134 Prevatt Rd, Ste. 1, Dothan, AL 36301-5427 | 2010-02-04 |
| 1679753636 | Tammy Alecia Mccarter | Counselor | 134 Prevatt Rd, Dothan, AL 36301-5427 | 2007-11-07 |
| 1144429325 | Robin Gay Quire | Registered Nurse | 134 Prevatt Rd, Dothan, AL 36301-5427 | 2007-07-17 |
| 1134328156 | Diana Phelps Golson | Registered Nurse | 134 Prevatt Rd, Dothan, AL 36301-5427 | 2007-07-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043862931 | Pharmacy Center South LLC | Pharmacy | 2826 Ross Clark Circle, Suite 103, Dothan, AL 36301 | 2019-07-11 |
| 1851879167 | Attallah Cotton | Social Worker | 101 Eastridge Dr, Dothan, AL 36301 | 2018-07-31 |
| 1225522709 | Nichole Johnson Prestwood | Nurse Practitioner | 2431 W Main St Ste 501, Dothan, AL 36301 | 2018-06-19 |
| 1750805818 | Kimberly Danielle Austin | Speech-Language Pathologist | 404 Darlington Cir, Dothan, AL 36301 | 2017-07-31 |
| 1952794885 | Lori P. Granberry | Pharmacist | 2131 Ross Clark Circle, Dothan, AL 36301 | 2015-03-17 |
| 1801286059 | Robert Cody Russell | Nurse Practitioner | 1118 Ross Clark Circle, Suite 100, Dothan, AL 36301 | 2015-01-27 |
| 1720407646 | Michael Kreger | Anesthesiology | 1118 Ross Clark Cir Ste 700, Dothan, AL 36301 | 2014-04-08 |
| 1063851277 | Carlos Stanford Clark II | Family Medicine | 201 Doctors Drive, Dothan, AL 36301 | 2013-06-20 |
| 1639489313 | Robert Fort Hambaugh Jr. | Specialist | 712 Woodland Drive, Dothan, AL 36301 | 2010-10-15 |
| 1588894976 | Atwill Lamar Miller Jr. | Urology | 1908 Fairview Avenue, Dothan, AL 36301 | 2009-07-20 |
| Find all providers in zip 36301 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| 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. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841789294 | The Right Direction, LLC | Clinic/Center | 309 Ameris Ave, Dothan, AL 36305-7338 | 2018-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881225738 | Kendyl Hensley LLC | Clinic/Center | 1697 Hawthorne Ln, Prattville, AL 36066-7346 | 2020-01-29 |
| 1578048815 | New Leaf Counseling Services of The Tn Valley LLC | Clinic/Center | 250 Sun Temple Dr Ste C1, Madison, AL 35758-5925 | 2018-10-02 |
| 1851897920 | Isbell Counseling, LLC | Clinic/Center | 2415 Waid Cir N, Southside, AL 35907-7043 | 2018-04-05 |
| 1730689738 | Blissful Mind Behavioral Health | Clinic/Center | 207 Eustis Ave Se Ste D, Huntsville, AL 35801-4234 | 2018-02-15 |
| 1124574074 | Peulthai House/behavioral Health Day Treatment Center | Clinic/Center | 14881 G Hwy 231/431, North Hazel Green, AL 35750 | 2016-08-31 |
| 1619347325 | Pinnacle Behavioral Health, Inc | Clinic/Center | 2800 Bob Wallace Ave Sw, Huntsville, AL 35805-4154 | 2015-10-07 |
| 1902216203 | Rudolph Bolling Psychiatry PC | Clinic/Center | 201 Beacon Pkwy W Ste 201, Birmingham, AL 35209-3129 | 2014-05-07 |
| 1750480752 | Tuscaloosa Juvenile Detention Center | Clinic/Center | 6001 12th Ave E, Tuscaloosa, AL 35405-5163 | 2006-09-22 |
| 1922010651 | Specialized Alternatives for Families and Youth of America, Inc. | Clinic/Center | 9532 Wynlakes Pl, Montgomery, AL 36117-8515 | 2006-08-12 |
| 1760439590 | Hc Parternership | Clinic/Center | 6869 5th Avenue South, Birmingham, AL 35212-1866 | 2006-05-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.