Provider Demographics
NPI:1114468824
Name:MONTGOMERY BAPTIST ASSOCIATION
Entity Type:Organization
Organization Name:MONTGOMERY BAPTIST ASSOCIATION
Other - Org Name:BAPTIST FAMILY RESOURCE AND COUNSELING
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF MISSIONS/TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:NEAL
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:REV
Authorized Official - Phone:334-271-6227
Mailing Address - Street 1:20 INTERSTATE PARK DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36109-5417
Mailing Address - Country:US
Mailing Address - Phone:334-271-6241
Mailing Address - Fax:334-271-4180
Practice Address - Street 1:20 INTERSTATE PARK DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36109-5417
Practice Address - Country:US
Practice Address - Phone:334-271-6241
Practice Address - Fax:334-271-4180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-14
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL218101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty