Provider Demographics
NPI:1417016528
Name:ALABAMA AEGIS, INC.
Entity Type:Organization
Organization Name:ALABAMA AEGIS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:THAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:250-871-2007
Mailing Address - Street 1:2910 LINDEN AVE
Mailing Address - Street 2:STE. 203
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-2531
Mailing Address - Country:US
Mailing Address - Phone:205-871-2007
Mailing Address - Fax:205-871-2014
Practice Address - Street 1:2910 LINDEN AVE
Practice Address - Street 2:STE. 203
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-2531
Practice Address - Country:US
Practice Address - Phone:205-871-2007
Practice Address - Fax:205-871-2014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPIP-255-0490C104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALPIP-255-0490COtherSOCIAL WORK LICENSE