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General NPI Number Information
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NPI Number | 1518466176
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Entity Type | Organization
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Legal Business Name | ALABAMA FOUNDATION OF THERAPEUTIC SERVICES, INC
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Dates
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Enumeration Date | 02/08/2018
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Last Update Date | 08/26/2018
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Provider Practice Location Address
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Address Line | 100 CENTURY PARK S STE 102
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City | BIRMINGHAM
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State | AL
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Zip | 35226
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Country | US
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Telephone | 205-656-6554
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Fax |
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Provider Business Mailing Address
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Address Line | 100 CENTURY PARK S STE 102
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City | BIRMINGHAM
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State | AL
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Zip | 35226-3922
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Country | US
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Telephone | 205-200-5351
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE DIRECTOR
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Name | MR. CARLOS DEWAYNE RICHARDSON
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Credential | LPC
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Telephone | 205-200-5351
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 3834
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 3834
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License Number State | AL
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Taxonomy #4
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | 3834
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License Number State | AL
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Taxonomy #5
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3834
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License Number State | AL
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