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General NPI Number Information
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NPI Number | 1376699116
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Entity Type | Organization
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Legal Business Name | COMMUNITY SERVICE PROGRAMS OF WEST AL INC
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 04/30/2008
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Provider Practice Location Address
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Address Line | 2002 MCFARLAND BLVD E SUITE 209
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City | TUSCALOOSA
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State | AL
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Zip | 35404
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Country | US
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Telephone | 205-752-0476
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Fax | 205-752-8122
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Provider Business Mailing Address
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Address Line | 601 17TH STREET
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City | TUSCALOOSA
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State | AL
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Zip | 35401-6311
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Country | US
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Telephone | 205-752-0476
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Fax | 205-752-8122
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Authorized Official
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Title or Position | SUPERVISOR
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Name | MARY BETH VICK
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Credential |
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Telephone | 205-752-0476
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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