MEDICARE: ALABAMA COURT SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	2224G	AL

General Provider Information

NPI Number	:	1720265440
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALABAMA COURT SERVICES

Provider Business Mailing Address
First Line	:	2531 MEADOWVIEW LN
Second Line	:	SUITE D
City	:	PELHAM
State	:	AL
Zip	:	35124-4343
Country	:	US
Telephone Number	:	205-447-0400
Fax Number	:

Provider Business Practice Location Address
First Line	:	1128 E LAKE BLVD
Second Line	:	SUITE 110
City	:	BIRMINGHAM
State	:	AL
Zip	:	35217-2446
Country	:	US
Telephone Number	:	205-849-1012
Fax Number	:	205-849-1014

Authorized Official
Title or Position	:	VICE PRESIDENT/ CO-OWNER
Name	:	MRS. SHANNON POLSON
Credential	:	MSW, LGSW
Telephone Number	:	205-447-0400

Provider Enumeration Date	:	01/24/2008
Last Update Date	:	01/24/2008

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