NPIMap

Organization Active NPI

Marshall Jackson Mental Health Board, Inc. - Ccbhc

Doing business as Mountain Lakes Behavioral Healthcare-CCBHC

  • Community/Behavioral Health Agency
  • Guntersville, AL
National Provider Identifier
1659179208
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MARSHALL JACKSON MENTAL HEALTH BOARD, INC. - CCBHC
Doing business as
Mountain Lakes Behavioral Healthcare-CCBHC
Practice address
2409 Homer Clayton Drive
Guntersville, AL 35976
Phone
(256) 582-3203
Fax
(256) 582-3216
NPI assigned
Mar 7, 2025
Last updated
Mar 7, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

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

Authorized official

Name
Cammy Holland
Title
Business Manager
Phone
(256) 582-4240

Specialties & licenses 1

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

Addresses

Primary practice location

2409 Homer Clayton Drive
Guntersville, AL 35976

Mailing address

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

Other names 1

  • Mountain Lakes Behavioral Healthcare-CCBHC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Marshall-Jackson MHC Allkids Plus3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

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

NPI Registry JSON

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

{
    "created_epoch": "1741305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741305600000",
    "number": "1659179208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2409 HOMER CLAYTON DRIVE",
            "city": "GUNTERSVILLE",
            "state": "AL",
            "postal_code": "35976",
            "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 DRIVE",
            "city": "GUNTERSVILLE",
            "state": "AL",
            "postal_code": "35976",
            "telephone_number": "256-582-3203",
            "fax_number": "256-582-3216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARSHALL JACKSON MENTAL HEALTH BOARD, INC. - CCBHC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-07",
        "last_updated": "2025-03-07",
        "status": "A",
        "authorized_official_last_name": "HOLLAND",
        "authorized_official_first_name": "CAMMY",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "256-582-4240"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain Lakes Behavioral Healthcare-CCBHC",
            "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 Mar 7, 2025; 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.