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General NPI Number Information
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NPI Number | 1093068199
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Entity Type | Organization
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Legal Business Name | WORKING ON WOMANHOOD PROGRAM
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Dates
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Enumeration Date | 10/26/2012
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Last Update Date | 10/26/2012
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Provider Practice Location Address
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Address Line | 6001 12TH AVE E STE B
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City | TUSCALOOSA
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State | AL
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Zip | 35405-5163
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Country | US
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Telephone | 205-343-2875
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Fax |
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Provider Business Mailing Address
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Address Line | BOX 870317
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City | TUSCALOOSA
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State | AL
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Zip | 35487-0317
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Country | US
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Telephone | 205-343-2875
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | KARAN SINGLEY
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Credential |
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Telephone | 205-348-2992
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | C30210114
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License Number State | AL
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