NPI Code Details Logo

NPI 1649325788

NPI 1649325788 : COMMUNITY SERVICE PROGRAMS OF WEST ALABAMA INC : TUSCALOOSA, AL

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1649325788
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    COMMUNITY SERVICE PROGRAMS OF WEST ALABAMA INC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    01/25/2007
-----------------------------------------------------
    Last Update Date     |    09/11/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    2002 MCFARLAND BLVD E SUITE 209
-----------------------------------------------------
    City                 |    TUSCALOOSA
-----------------------------------------------------
    State                |    AL
-----------------------------------------------------
    Zip                  |    35404-5805
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    205-752-0476
-----------------------------------------------------
    Fax                  |    205-752-8122
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    601 17TH ST 
-----------------------------------------------------
    City                 |    TUSCALOOSA
-----------------------------------------------------
    State                |    AL
-----------------------------------------------------
    Zip                  |    35401-4807
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    205-752-5429
-----------------------------------------------------
    Fax                  |    205-752-8653
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    DIRECTOR
-----------------------------------------------------
    Name                 |    MS. CYNTHIA  BURTON 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    205-752-5429
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    2251P0200X
-----------------------------------------------------
    Taxonomy Name        |    Pediatric Physical Therapist
-----------------------------------------------------
    License Number       |    PTH2409
-----------------------------------------------------
    License Number State |    AL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    225XP0200X
-----------------------------------------------------
    Taxonomy Name        |    Pediatric Occupational Therapist
-----------------------------------------------------
    License Number       |    0207
-----------------------------------------------------
    License Number State |    AL
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
    Taxonomy Code        |    235Z00000X
-----------------------------------------------------
    Taxonomy Name        |    Speech-Language Pathologist
-----------------------------------------------------
    License Number       |    2078
-----------------------------------------------------
    License Number State |    AL
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
    Taxonomy Code        |    235Z00000X
-----------------------------------------------------
    Taxonomy Name        |    Speech-Language Pathologist
-----------------------------------------------------
    License Number       |    453
-----------------------------------------------------
    License Number State |    AL
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
    Taxonomy Code        |    251B00000X
-----------------------------------------------------
    Taxonomy Name        |    Case Management Agency
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.