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Contract Details
Fast Pace Medical Clinic, PPLC
Facility name
FastPace Behavioral Health
Provider ID
P000000001
Tax ID
270851352
Effective Date
3/1/2023
Last Updated
3/28/2023
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
2731 Allison Bonnett Memorial Drive
Hueytown, AL 35023
United States
Phone
205-548-4102
(
Phone
)
Fax
205-548-4103
Billing Details
Address
2731 Allison Bonnett Memorial Drive
Hueytown, AL 35023
Billing Phone
205-548-4102
Specialty Type
Counselor - Professional
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