Provider Demographics
NPI:1073649042
Name:EAST CENTRAL ALABAMA UNITED CEREBRAL PALSY INC
Entity Type:Organization
Organization Name:EAST CENTRAL ALABAMA UNITED CEREBRAL PALSY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:D
Authorized Official - Last Name:JOHNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-237-8203
Mailing Address - Street 1:301 E A DARDEN DR
Mailing Address - Street 2:P O BOX 694
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36201-2183
Mailing Address - Country:US
Mailing Address - Phone:256-237-8203
Mailing Address - Fax:256-235-2388
Practice Address - Street 1:301 EA DARDEN DR
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36201-2183
Practice Address - Country:US
Practice Address - Phone:256-237-8203
Practice Address - Fax:256-235-2388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1982757688Medicaid
AL1528110798Medicaid