Healthcare Provider Details

I. General information

NPI: 1932380706
Provider Name (Legal Business Name): HUMAN RESOURCE DEVELOPMENT INSTITUE-ALABAMA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2007
Last Update Date: 11/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 S JEFFERSON ST SUITE 200
CHICAGO IL
60661-5603
US

IV. Provider business mailing address

4111 WALL ST SUITE B
MONTGOMERY AL
36106-2926
US

V. Phone/Fax

Practice location:
  • Phone: 312-441-9009
  • Fax:
Mailing address:
  • Phone: 334-396-9551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number StateAL

VIII. Authorized Official

Name: MR. EFFIE G. BARNER
Title or Position: BILLING MANAGER
Credential:
Phone: 312-441-9009