MEDICARE: HUMAN RESOURCE DEVELOPMENT INSTITUE-ALABAMA

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	320800000X	Mental Illness Community Based Residential Treatment Facility
2	320800000X	Mental Illness Community Based Residential Treatment Facility		AL

General Provider Information

NPI Number	:	1932380706
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUMAN RESOURCE DEVELOPMENT INSTITUE-ALABAMA

Provider Business Mailing Address
First Line	:	4111 WALL ST
Second Line	:	SUITE B
City	:	MONTGOMERY
State	:	AL
Zip	:	36106-2926
Country	:	US
Telephone Number	:	334-396-9551
Fax Number	:

Provider Business Practice Location Address
First Line	:	222 S JEFFERSON ST
Second Line	:	SUITE 200
City	:	CHICAGO
State	:	IL
Zip	:	60661-5603
Country	:	US
Telephone Number	:	312-441-9009
Fax Number	:

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	MR. EFFIE G. BARNER
Credential	:
Telephone Number	:	312-441-9009

Provider Enumeration Date	:	11/20/2007
Last Update Date	:	11/20/2007

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