Healthcare Provider Details

I. General information

NPI: 1932112877
Provider Name (Legal Business Name): SERAAJ FAMILY HOMES, INC,
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 COTTON GIN RD
MONTGOMERY AL
36117-3557
US

IV. Provider business mailing address

PO BOX 230550
MONTGOMERY AL
36123-0550
US

V. Phone/Fax

Practice location:
  • Phone: 334-271-2402
  • Fax: 334-271-2405
Mailing address:
  • Phone: 334-271-2402
  • Fax: 334-271-2405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number022587
License Number StateAL

VIII. Authorized Official

Name: ABDUL S SERAAJ
Title or Position: CEO
Credential:
Phone: 334-271-2402