Blanket Fort Hope

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

BLANKET FORT HOPE

Practice address

24809 Alabama Highway 25
Columbiana, AL 35051-3512

Phone

(205) 602-4892

Fax

(205) 602-4892

NPI assigned

Feb 13, 2024

Last updated

Feb 13, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Kimberly W Mashego, LICSWNPI 1316711781

Title

Executive Director

Phone

(205) 602-4892

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kimberly Wallace Mashego, LICSW-S

  • Clinical Social Worker
  • Columbiana, AL
  • NPI 1316711781
  NPD Authorized official
• Gabriella Perry, LMSW

  • Clinical Social Worker
  • Columbiana, AL
  • NPI 1558243543
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1707782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707782400000",
    "number": "1255195897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 212",
            "city": "COLUMBIANA",
            "state": "AL",
            "postal_code": "350510212",
            "telephone_number": "205-602-4892",
            "fax_number": "205-602-4892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24809 ALABAMA HIGHWAY 25",
            "city": "COLUMBIANA",
            "state": "AL",
            "postal_code": "350513512",
            "telephone_number": "205-602-4892",
            "fax_number": "205-602-4892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLANKET FORT HOPE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-13",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-12",
        "status": "A",
        "authorized_official_last_name": "MASHEGO",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "205-602-4892",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alabama CVS Pharmacy, L.L.C. (CVS Pharmacy #04866)
• Andrews Family Dental, LLC
• George Carpenter Andrews Jr., DMD
• Alex Keith Bacon
• Bryce Kennen Bird
• Elizabeth Ann Bolen, NP
• Brooke M Brown, LGSW
• Megan V Bullard, M.D.
• Monica C Burson, PT
• James Michael Byrd, PHARM.D

• Adolescent and Children Mental Health Clinic/Center in Columbiana, AL
• Providers in Columbiana, AL by specialty
• Adolescent and Children Mental Health Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.