NPIMap

Organization Active NPI

East Central Mental Health Mental Retardation, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Troy, AL
National Provider Identifier
1285717413
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
EAST CENTRAL MENTAL HEALTH MENTAL RETARDATION, INC.
Practice address
200 Cherry St
Troy, AL 36081-2044
Phone
(334) 566-6022
Fax
(334) 566-5346
NPI assigned
Oct 23, 2006
Last updated
Jun 21, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Mrs. Malvia G Frye
Title
Business Office Manager
Phone
(334) 566-6022

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

200 Cherry St
Troy, AL 36081-2044

Mailing address

200 Cherry St
Troy, AL 36081-2044
Phone (334) 566-6022

Other identifiers 7

IdentifierTypeStateIssuer
510-08117OtherALBCBS PPO PLANS
6232119OtherALUBH
6242119OtherALUBH
51022653OtherALBCBS DR.
6342119OtherALUBH
6231195OtherALUBH
8401000MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040601001053 AL Part B Supplier - Clinic/Group Practice 3870575202 Receives reassigned benefits from 6 practitioners
Practice locations: Troy, AL; Union Springs, AL; Union City, AL; Tuskegee, AL

National Provider Directory

National Provider Directory
Tax ID family
East Central Mental Health Mental Retardation Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1655 Elba Hwy
Troy, AL 36079
Phone (334) 566-6022

207 Walters St
Troy, AL 36079
Phone (334) 566-6022

103 E Oak St
Tuskegee, AL 36083
Phone (334) 566-6022

202 Abercrombie St S
Union Springs, AL 36089
Phone (334) 566-6022

209 Abercrombie St S
Union Springs, AL 36089
Phone (334) 566-6022

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1285717413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CHERRY ST",
            "city": "TROY",
            "state": "AL",
            "postal_code": "360812044",
            "telephone_number": "334-566-6022",
            "fax_number": "334-566-5346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CHERRY ST",
            "city": "TROY",
            "state": "AL",
            "postal_code": "360812044",
            "telephone_number": "334-566-6022",
            "fax_number": "334-566-5346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST CENTRAL MENTAL HEALTH MENTAL RETARDATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "FRYE",
        "authorized_official_first_name": "MALVIA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "334-566-6022",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PPO PLANS",
            "identifier": "510-08117",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH",
            "identifier": "6232119",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH",
            "identifier": "6242119",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS DR.",
            "identifier": "51022653",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH",
            "identifier": "6342119",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH",
            "identifier": "6231195",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8401000",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.