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General NPI Number Information
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NPI Number | 1861497935
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Entity Type | Organization
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Legal Business Name | HOSPICE OF WEST ALABAMA, INC.
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Dates
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Enumeration Date | 06/16/2005
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Last Update Date | 07/12/2012
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Provider Practice Location Address
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Address Line | 3851 LOOP RD
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City | TUSCALOOSA
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State | AL
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Zip | 35404-5040
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Country | US
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Telephone | 205-523-0101
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Fax | 205-523-0102
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Provider Business Mailing Address
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Address Line | 3851 LOOP RD
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City | TUSCALOOSA
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State | AL
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Zip | 35404-5040
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Country | US
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Telephone | 205-523-0101
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Fax | 205-523-0102
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. LATRELLE PORTER BELL
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Credential | LBSW
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Telephone | 205-523-0101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 10278
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License Number State | AL
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