Provider Demographics
NPI:1083886683
Name:UNITED CEREBRAL PALSY OF GREATER BIRMINGHAM
Entity Type:Organization
Organization Name:UNITED CEREBRAL PALSY OF GREATER BIRMINGHAM
Other - Org Name:UCP-TARGETED CASE MANAGEMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:T
Authorized Official - Last Name:MATHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-608-1465
Mailing Address - Street 1:PO BOX 1550
Mailing Address - Street 2:
Mailing Address - City:GARDENDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35071-1550
Mailing Address - Country:US
Mailing Address - Phone:205-608-1465
Mailing Address - Fax:205-608-0166
Practice Address - Street 1:120 OSLO CIR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-5965
Practice Address - Country:US
Practice Address - Phone:205-944-3930
Practice Address - Fax:205-944-3990
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNITED CEREBRAL PALSY OF GREATER BIRMINGHAM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-24
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL590700000Medicaid