WIREGRASS BEHAVIORAL GROUP LLC (NPI# 1821609389) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821609389 |
| Entity Type | Organization |
| Organization Name | WIREGRASS BEHAVIORAL GROUP LLC |
| Practice Address |
256 Honeysuckle Rd Ste 12 Dothan AL 36305-1168 |
| Practice Telephone | 3347926736 |
| Practice Fax Number | 3347926737 |
| Mailing Telephone | 3347926736 |
| Mailing Fax Number | 3347926737 |
| Enumeration Date | 2020-08-10 |
| Last Update Date | 2020-08-13 |
| Authorized Official Name | MISS PHILLIP JOHNSON (PRESIDENT) |
| Authorized Official Telephone | 3347926736 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Street Address |
256 HONEYSUCKLE RD STE 12 |
| City | DOTHAN |
| State | AL |
| Zip Code | 36305-1168 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194353672 | Jamison Behavioral Wellness LLC | Psychiatry & Neurology | 256 Honeysuckle Rd Ste 12, Dothan, AL 36305-1168 | 2020-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962059998 | Samantha Nicole Bolden | Counselor | 1001 John D. Odom Road, Dothan, AL 36305 | 2019-08-23 |
| 1578968780 | Aba Therapy & Consulting Services | Behavioral Analyst | 3124 West Main Street, Suite 9, Dothan, AL 36305 | 2014-10-30 |
| 1306247796 | Tracey Lynn Carter | Registered Nurse | 4300 W Main St Ste 102, Dothan, AL 36305 | 2014-09-04 |
| 1760829881 | Michael Brent Nance | Nurse Practitioner | 4370 West Main Street, Dothan, AL 36305 | 2013-05-30 |
| 1033495221 | Professional Resource Management of Wiregrass, LLC | Psychiatry & Neurology | 2812 Hartford Hwy Ste 1, Dothan, AL 36305 | 2011-11-01 |
| 1649555483 | Ashley Dawn Morrow | Pharmacist | 2940 West Main Street, Dothan, AL 36305 | 2011-10-12 |
| 1740599273 | Aline M Mays-easley | Counselor | 309 Ameris Ave, Dothan, AL 36305 | 2010-10-01 |
| 1356671408 | Kimberly Jones Rogers | Clinical Neuropsychologist | 200 Grove Park Ln Ste 212, Dothan, AL 36305 | 2010-01-12 |
| 1639347818 | Southeast Alabama Counseling & Behavioral Specialist | Residential Treatment Facility, Emotionally Disturbed Children | 407 Honeysuckle Rd Ste 207, Dothan, AL 36305 | 2008-02-11 |
| 1770705667 | Michala Long | Pharmacist | 3850 West Main St, Dothan, AL 36305 | 2007-05-02 |
| Find all providers in zip 36305 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831740489 | Regenerative Medicine of Alabama | Clinic/Center | 2500 Flowers Chapel Rd, Dothan, AL 36305-8300 | 2019-09-25 |
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| 1689137705 | Wecare Tlc- Poa Hoover | Clinic/Center | 4745 Chace Cir Ste 101, Hoover, AL 35244-3713 | 2019-04-08 |
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| 1124590468 | Ross Bridge Medical Center Pediatrics, LLC | Clinic/Center | 3635 Market St Ste B, Birmingham, AL 35226-6391 | 2018-12-27 |
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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.