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General NPI Number Information
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NPI Number | 1194075085
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Entity Type | Organization
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Legal Business Name | MORGAN COUNTY SYSTEM OF SERVICES, INC.
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Dates
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Enumeration Date | 09/18/2012
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Last Update Date | 10/24/2012
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Provider Practice Location Address
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Address Line | 1611 CHURCH ST SE
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City | DECATUR
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State | AL
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Zip | 35601-3401
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Country | US
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Telephone | 256-584-0380
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Fax | 256-584-0382
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Provider Business Mailing Address
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Address Line | PO BOX 1124 2531 HIGHWAY 20 WEST
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City | DECATUR
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State | AL
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Zip | 35602-1124
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Country | US
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Telephone | 256-350-8434
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Fax | 256-350-8534
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | DR. SARA BRUCE HALL
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Credential | PHD
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Telephone | 256-350-8434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State | AL
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