Provider Demographics
NPI:1235765777
Name:EBAM SERVICES
Entity Type:Organization
Organization Name:EBAM SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MELVA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUPREE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-296-0817
Mailing Address - Street 1:3106 FIELDCREST DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-3333
Mailing Address - Country:US
Mailing Address - Phone:334-296-0817
Mailing Address - Fax:
Practice Address - Street 1:3106 FIELDCREST DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-3333
Practice Address - Country:US
Practice Address - Phone:334-296-0817
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-17
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
4018OtherHOME