Healthcare Provider Details

I. General information

NPI: 1164563060
Provider Name (Legal Business Name): CINDY HABER CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 05/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23214 E CHICAGO ST
ROBERTSDALE AL
36567
US

IV. Provider business mailing address

PO BOX 853
ROBERTSDALE AL
36567-0853
US

V. Phone/Fax

Practice location:
  • Phone: 251-947-5608
  • Fax: 251-947-6020
Mailing address:
  • Phone: 251-947-5608
  • Fax: 251-947-6020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number StateAL

VIII. Authorized Official

Name: DAWN LINDSEY
Title or Position: CASE MANAGER SUPERVISOR
Credential:
Phone: 251-947-5608