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General NPI Number Information
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NPI Number | 1215196746
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Entity Type | Organization
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Legal Business Name | UNIVERSAL CARE
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Dates
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Enumeration Date | 06/09/2008
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Last Update Date | 06/09/2008
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Provider Practice Location Address
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Address Line | 1414 26TH STREET 1414 26TH STREET
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City | TUSCALOOSA
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State | AL
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Zip | 35401-6642
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Country | US
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Telephone | 205-752-6081
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Fax |
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Provider Business Mailing Address
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Address Line | 1414 26TH STREET 1414 26TH STREET
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City | TUSCALOOSA
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State | AL
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Zip | 35401-6642
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Country | US
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Telephone | 205-752-6081
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Fax |
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Authorized Official
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Title or Position | SOCIAL ASSISTANCE/PERSONAL CARE
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Name | SUNDRA RENEE JOHNSON
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Credential |
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Telephone | 205-752-6081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number | 102375
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 102375
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License Number State | AL
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