Healthcare Provider Details

I. General information

NPI: 1235345893
Provider Name (Legal Business Name): N D A OF ALABAMA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 L V STABLER DR
GREENVILLE AL
36037-3850
US

IV. Provider business mailing address

29 L V STABLER DR
GREENVILLE AL
36037-3850
US

V. Phone/Fax

Practice location:
  • Phone: 334-383-2249
  • Fax: 334-383-2342
Mailing address:
  • Phone: 334-383-2249
  • Fax: 334-383-2342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State

VIII. Authorized Official

Name: MRS. DEBRA L TURNER
Title or Position: PHYSICIAN PRACTICE ANALYST
Credential:
Phone: 615-321-5577