Provider Demographics
NPI:1124189162
Name:UNITED CEREBRAL PALSY OF MOBILE INC
Entity Type:Organization
Organization Name:UNITED CEREBRAL PALSY OF MOBILE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:R
Authorized Official - Last Name:HARGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-479-4900
Mailing Address - Street 1:3058 DAUPHIN SQUARE CONNECTOR
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36607
Mailing Address - Country:US
Mailing Address - Phone:251-479-4900
Mailing Address - Fax:251-479-4998
Practice Address - Street 1:3058 DAUPHIN SQ CONNECTOR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-2500
Practice Address - Country:US
Practice Address - Phone:251-479-4900
Practice Address - Fax:251-479-4998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management