| Tabia Keonna Woolfork Recreational Mental Health Fitness Facility | |
|
853 S Court St Montgomery AL 36104-4905 | |
| (334) 647-1880 | |
| Not Available |
| Full Name | Tabia Keonna Woolfork Recreational Mental Health Fitness Facility |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 853 S Court St, Montgomery, Alabama |
| Authorized Official Name and Position | Peggie Lee Hatten (FOUNDER) |
| Authorized Official Contact | 3346471880 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tabia Keonna Woolfork Recreational Mental Health Fitness Facility 6021 Portsmouth Ct Montgomery AL 36116-7103 Ph: (334) 538-5529 | Tabia Keonna Woolfork Recreational Mental Health Fitness Facility 853 S Court St Montgomery AL 36104-4905 Ph: (334) 647-1880 |
| NPI Number | 1639805500 |
|---|---|
| Provider Enumeration Date | 07/25/2022 |
| Last Update Date | 07/25/2022 |
| Certification Date | 07/25/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639805500 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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