Healthcare Provider Details

I. General information

NPI: 1538405683
Provider Name (Legal Business Name): R&R GROUPHOMES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2012
Last Update Date: 12/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1502 FAYE ST SW 1502 FAYE ST SW
DECATUR AL
35601-2731
US

IV. Provider business mailing address

1502 FAYE ST SW 1502 FAYE ST SW
DECATUR AL
35601-2731
US

V. Phone/Fax

Practice location:
  • Phone: 256-214-1275
  • Fax: 256-340-9353
Mailing address:
  • Phone: 256-214-1275
  • Fax: 256-340-9353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: TARA P GORDON
Title or Position: CEO
Credential:
Phone: 256-214-1275