Provider Demographics
NPI:1164571725
Name:EASTER SEALS OF THE BIRMINGHAM AREA
Entity Type:Organization
Organization Name:EASTER SEALS OF THE BIRMINGHAM AREA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:SENN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-942-6277
Mailing Address - Street 1:2685 PELHAM PARKWAY
Mailing Address - Street 2:SUITE C
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124
Mailing Address - Country:US
Mailing Address - Phone:205-621-6503
Mailing Address - Fax:205-621-6507
Practice Address - Street 1:2685 PELHAM PARKWAY
Practice Address - Street 2:SUITE C
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124
Practice Address - Country:US
Practice Address - Phone:205-621-6503
Practice Address - Fax:205-621-6507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16432251P0200X
AL2384235Z00000X
AL2494235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL=========OtherTAX IDENTIFICATION NUMBER