Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X | |||
Addiction (Substance Use Disorder) |
101YA0400X | |||
Addiction Medicine |
2084A0401X | 79 | Physician/Addiction Medicine | |
Clinical |
1041C0700X | 80 | Licensed Clinical Social Worker |
| NPI Number | 1659108587 |
| LBN Legal business name | MAYO BEHAVIORAL HEALTH SERVICES |
| Authorized official | BRITTNEY MAYO - (OWNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 09/16/2024 |
| Last updated | 09/16/2024 - More than a year ago |
| Identifiers | n/a |
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