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Serving Alabama clients since 2015
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(256) 489-0046
Athens:
102 / 100 Sanders Street
Athens, AL 35611
Huntsville:
115 Manning DR SW Ste A202 Huntsville, AL 35801
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Medicaid Referral Form
Fax the following information to our office:
- EPSDT Referral Form Required by Medicaid (Ages 5-20 only)
- Can only be a referral from a Medicaid PCP Approved Provider (Psychiatrists and PMHNPs cannot refer)
Athens Office:
102 / 100 Sanders Street
Athens, AL 35611
Huntsville Office:
115 Manning DR SW Suite A202
Huntsville, AL 35801