NPIMap

Organization Active NPI

Marshall-Jackson MHC Allkids Plus

Doing business as Mt. Lakes Behavioral Healthcare

  • Community/Behavioral Health Agency
  • Guntersville, AL
National Provider Identifier
1548435027
Registry record updated Apr 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MARSHALL-JACKSON MHC ALLKIDS PLUS
Doing business as
Mt. Lakes Behavioral Healthcare
Practice address
2409 Homer Clayton Dr
Guntersville, AL 35976-2207
Phone
(256) 582-3203
Fax
(256) 582-3216
NPI assigned
Apr 25, 2008
Organization subpart
Yes
Parent organization
MARSHALL-JACKSON MENTAL HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 25, 2008

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

Authorized official

Name
Mr. Kert Reedstrom
Title
Executive Director
Phone
(256) 582-4240

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

2409 Homer Clayton Dr
Guntersville, AL 35976-2207

Mailing address

2409 Homer Clayton Dr
Guntersville, AL 35976-2207
Phone (256) 582-3203

Other identifiers 1

IdentifierTypeStateIssuer
51511698OtherALBCBS ALLKIDS PLUS

Other names 1

  • MT. LAKES BEHAVIORAL HEALTHCARE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Marshall-Jackson Mental Health BD Inc3 organizations share this tax ID, including this one
Part of
Marshall-Jackson Mental Health BD Inc

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209081600000",
    "number": "1548435027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2409 HOMER CLAYTON DR",
            "city": "GUNTERSVILLE",
            "state": "AL",
            "postal_code": "359762207",
            "telephone_number": "256-582-3203",
            "fax_number": "256-582-3216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2409 HOMER CLAYTON DR",
            "city": "GUNTERSVILLE",
            "state": "AL",
            "postal_code": "359762207",
            "telephone_number": "256-582-3203",
            "fax_number": "256-582-3216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARSHALL-JACKSON MHC ALLKIDS PLUS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARSHALL-JACKSON MENTAL HEALTH CENTER",
        "enumeration_date": "2008-04-25",
        "last_updated": "2008-04-25",
        "status": "A",
        "authorized_official_last_name": "REEDSTROM",
        "authorized_official_first_name": "KERT",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "256-582-4240",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ALLKIDS PLUS",
            "identifier": "51511698",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MT. LAKES BEHAVIORAL HEALTHCARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Guntersville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; 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.