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General NPI Number Information
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NPI Number | 1750524476
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Entity Type | Organization
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Legal Business Name | LITTLE CRF LLC
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Dates
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Enumeration Date | 04/10/2009
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Last Update Date | 04/10/2009
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Provider Practice Location Address
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Address Line | 5505 JUG FACTORY RD LOT 20
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City | TUSCALOOSA
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State | AL
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Zip | 35405-5265
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Country | US
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Telephone | 205-366-9953
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Fax | 205-349-2973
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Provider Business Mailing Address
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Address Line | PO BOX 70036 LOT 20
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City | TUSCALOOSA
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State | AL
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Zip | 35407-0036
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Country | US
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Telephone | 205-366-9953
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Fax | 205-349-2973
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. CAROLYN LITTLE H
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Credential |
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Telephone | 205-366-9953
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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