Provider Demographics
NPI:1902790579
Name:SELF RELIANCE BEHAVIORAL HEALTH, LLC
Entity type:Organization
Organization Name:SELF RELIANCE BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:TAMIKA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:205-569-4770
Mailing Address - Street 1:2108 ROCKY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35216-5138
Mailing Address - Country:US
Mailing Address - Phone:205-569-4770
Mailing Address - Fax:
Practice Address - Street 1:2108 ROCKY RIDGE RD
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35216-5138
Practice Address - Country:US
Practice Address - Phone:205-569-4770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-06
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty