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NPI Code Detail

MEDICARE: HOWARD'S HOUSE LLC

MEDICARE: HOWARD'S HOUSE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1320900000XIntellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityAL

General Provider Information

NPI Number : 1588953921
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOWARD'S HOUSE LLC
Provider Business Mailing Address
First Line : 4418 WINCHESTER RD
Second Line :
City : EIGHT MILE
State : AL
Zip : 36613-3516
Country : US
Telephone Number : 251-452-0507
Fax Number :
Provider Business Practice Location Address
First Line : 4418 WINCHESTER RD
Second Line :
City : EIGHT MILE
State : AL
Zip : 36613-3516
Country : US
Telephone Number : 251-452-0507
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. MICHAEL A HOWARD
Credential :
Telephone Number : 251-281-4798
Provider Enumeration Date : 04/06/2011
Last Update Date : 04/06/2011

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