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General NPI Number Information
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NPI Number | 1689988891
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Entity Type | Organization
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Legal Business Name | JAMES RIVER SCLH
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Dates
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Enumeration Date | 07/29/2010
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Last Update Date | 07/29/2010
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Provider Practice Location Address
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Address Line | 5505 JAMES RIVER DR
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City | NORTHPORT
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State | AL
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Zip | 35473-1309
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Country | US
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Telephone | 205-333-3163
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Fax | 205-333-5926
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Provider Business Mailing Address
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Address Line | 5505 JAMES RIVER DR
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City | NORTHPORT
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State | AL
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Zip | 35473-1309
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Country | US
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Telephone | 205-333-3163
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Fax | 205-333-5926
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. GENEVA HINTON BROWN
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Credential | QMRP
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Telephone | 205-333-3163
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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