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General NPI Number Information
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NPI Number | 1154515591
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Entity Type | Organization
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Legal Business Name | CRENSHAW COUNTY HEALTH CARE AUTHORITY
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Dates
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Enumeration Date | 08/29/2007
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Last Update Date | 07/20/2020
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Provider Practice Location Address
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Address Line | 101 HOSPITAL CIR
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City | LUVERNE
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State | AL
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Zip | 36049-7329
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Country | US
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Telephone | 334-335-3374
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Fax | 334-335-1217
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Provider Business Mailing Address
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Address Line | 101 HOSPITAL CIR
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City | LUVERNE
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State | AL
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Zip | 36049-7329
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Country | US
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Telephone | 334-335-3374
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Fax | 334-335-1217
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Authorized Official
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Title or Position | CHAIRMAN
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Name | MICHAEL ANDREW KIMBRO
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Credential |
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Telephone | 334-335-3374
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | 11790
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License Number State | AL
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