Basic Information
| Provider Information | |||||||||
| NPI: | 1730396086 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | THE HEALTH CARE AUTHORITY OF LAUDERDALE COUNTY AND THE CITY OF FLORENC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | ECM PSYCHIATRIC ASSOCIATES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 10005 | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 356312005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2567689191 | ||||||||
| FaxNumber: | 2567689775 | ||||||||
| Practice Location | |||||||||
| Address1: | 541 W COLLEGE ST | ||||||||
| Address2: | SUITE 2000 | ||||||||
| City: | FLORENCE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 356305323 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2567688196 | ||||||||
| FaxNumber: | 2567689775 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2007 | ||||||||
| LastUpdateDate: | 10/10/2011 | ||||||||
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| AuthorizedOfficialLastName: | PIGG | ||||||||
| AuthorizedOfficialFirstName: | JODY | ||||||||
| AuthorizedOfficialMiddleName: | LEWIS | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 2567689191 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | THE HEALTH CARE AUTHORITY OF LAUDERDALE COUNTY AND THE CITY OF FLORENC | ||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 273R00000X | Y | Hospital Units | Psychiatric Unit |
No ID Information.