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General NPI Number Information
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NPI Number | 1902236334
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Entity Type | Organization
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Legal Business Name | ALABAMA WELLNESS AND RECOVERY SERVICES, LLC
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Dates
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Enumeration Date | 11/21/2013
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Last Update Date | 10/14/2015
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Provider Practice Location Address
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Address Line | 4898 VALLEYDALE RD SUITE B-1
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City | BIRMINGHAM
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State | AL
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Zip | 35242-4654
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Country | US
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Telephone | 205-306-1164
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Fax |
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Provider Business Mailing Address
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Address Line | 4898 VALLEYDALE RD SUITE B-1
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City | BIRMINGHAM
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State | AL
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Zip | 35242-4654
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Country | US
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Telephone | 205-306-1164
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JANET STOUDENMIRE
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Credential | MS, ALC, ICADC, SAP
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Telephone | 205-306-1164
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | C2055A
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License Number State | AL
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