WELLSTONE, INC.
Addiction Substance Use Disorder
Huntsville, Alabama
Provider NPI: 1407809213
Organization Information:Organization Name: WELLSTONE, INC.
Organization is not Subpart
Authorized Official: TORI L LOVELL HUMAN RESOURCES MANAGER 256-7056312
Practice Location:
4040 MEMORIAL PKWY SW HUNTSVILLE, AL 35802 US
Tel: 256-533-1970 Fax: 256-532-4141
Business Mailing Address:
4040 MEMORIAL PKWY SW HUNTSVILLE, AL 35802 US
Tel: 256-533-1970 Fax: 256-532-4141
Entity Type: Organization
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Organization is not Subpart
Authorized Official: TORI L LOVELL HUMAN RESOURCES MANAGER 256-7056312
Practice Location:
4040 MEMORIAL PKWY SW HUNTSVILLE, AL 35802 US
Tel: 256-533-1970 Fax: 256-532-4141
Business Mailing Address:
4040 MEMORIAL PKWY SW HUNTSVILLE, AL 35802 US
Tel: 256-533-1970 Fax: 256-532-4141
Entity Type: Organization
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 101YA0400X | Behavioral Health & Social Service Providers Counselor Addiction (Substance Use Disorder) | ||
Y | 101YM0800X | Behavioral Health & Social Service Providers Counselor | ||
N | 103TC0700X | Behavioral Health & Social Service Providers Psychologist | ||
N | 1041C0700X | Behavioral Health & Social Service Providers Social Worker | ||
N | 106H00000X | Behavioral Health & Social Service Providers Marriage & Family Therapist | ||
N | 2084P0800X | Physicians Psychiatry & Neurology | ||
N | 2084P0804X | Physicians Psychiatry & Neurology | ||
N | 2084P0805X | Physicians Psychiatry & Neurology |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
330000014 | AL | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
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