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NPI Code Detail

MEDICARE: THE SALVATION ARMY, A GEORGIA CORPORATION

MEDICARE: THE SALVATION ARMY, A GEORGIA CORPORATION
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
1322D00000XEmotionally Disturbed Childrens' Residential Treatment Facility005576AL

General Provider Information

NPI Number : 1750472932
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE SALVATION ARMY, A GEORGIA CORPORATION
Provider Business Mailing Address
First Line : 6001 CRESTWOOD BLVD
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35212-4203
Country : US
Telephone Number : 205-595-8343
Fax Number : 205-595-1996
Provider Business Practice Location Address
First Line : 6001 CRESTWOOD BLVD
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35212-4203
Country : US
Telephone Number : 205-595-8343
Fax Number : 205-595-1996
Authorized Official
Title or Position : VICE- PRESIDENT
Name : LT. COLONEL DAVID E. JEFFREY
Credential :
Telephone Number : 404-728-1300
Provider Enumeration Date : 09/27/2006
Last Update Date : 08/22/2020

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Directions to “THE SALVATION ARMY, A GEORGIA CORPORATION ” Practice Location

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