Healthcare Provider Details

I. General information

NPI: 1366521163
Provider Name (Legal Business Name): ASSOCIATION FOR RETARDED CITIZENS INC OF JEFFERSON COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 07/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 21ST AVE S
BIRMINGHAM AL
35205-6801
US

IV. Provider business mailing address

215 21ST AVE S
BIRMINGHAM AL
35205-6801
US

V. Phone/Fax

Practice location:
  • Phone: 205-323-6383
  • Fax: 205-323-0085
Mailing address:
  • Phone: 205-323-6383
  • Fax: 205-323-0085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: CHRIS STEWART
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 205-503-4040