Healthcare Provider Details

I. General information

NPI: 1578755013
Provider Name (Legal Business Name): CATHOLIC SOCIAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2007
Last Update Date: 08/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23010 HIGHWAY 59 NORTH
ROBERTSDALE AL
36567
US

IV. Provider business mailing address

PO BOX 870 23010 HWY. 59 N
ROBERTSDALE AL
36567-0870
US

V. Phone/Fax

Practice location:
  • Phone: 251-947-2293
  • Fax: 251-947-4058
Mailing address:
  • Phone: 251-947-2293
  • Fax: 251-947-4058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. MICHELE PROCKUP
Title or Position: DIRECTOR
Credential:
Phone: 251-947-2293