Healthcare Provider Details

I. General information

NPI: 1316027956
Provider Name (Legal Business Name): TUSCALOOSA COUNTY MENTAL RETARDATION AUTHORITY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1002 MCFARLAND BLVD SUITE K
NORTHPORT AL
35476-3370
US

IV. Provider business mailing address

1002 MCFARLAND BLVD SUITE K
NORTHPORT AL
35476-3370
US

V. Phone/Fax

Practice location:
  • Phone: 205-333-1577
  • Fax: 205-333-2904
Mailing address:
  • Phone: 205-333-1577
  • Fax: 205-333-2904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: VICKI HICKS TURNAGE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 205-333-1577