Healthcare Provider Details

I. General information

NPI: 1851463269
Provider Name (Legal Business Name): CULLMAN COUNTY CENTER FOR THE DEVELOPMENTALLY DISABLED, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1807 BEECH AVE SE
CULLMAN AL
35055-5462
US

IV. Provider business mailing address

1807 BEECH AVE SE
CULLMAN AL
35055-5462
US

V. Phone/Fax

Practice location:
  • Phone: 256-737-1915
  • Fax: 256-734-3231
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTH1597
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTH3944
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOTO266
License Number StateAL
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number1449
License Number StateAL
# 5
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: ANNA MCGILL
Title or Position: BILLING CLERK
Credential:
Phone: 256-737-1915