Provider Demographics
NPI:1417640806
Name:OFAROS LLC
Entity Type:Organization
Organization Name:OFAROS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:SETH
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:ALC
Authorized Official - Phone:205-605-8664
Mailing Address - Street 1:264 FOREST RD
Mailing Address - Street 2:
Mailing Address - City:HUEYTOWN
Mailing Address - State:AL
Mailing Address - Zip Code:35023-1657
Mailing Address - Country:US
Mailing Address - Phone:205-605-8664
Mailing Address - Fax:205-377-7439
Practice Address - Street 1:264 FOREST RD
Practice Address - Street 2:
Practice Address - City:HUEYTOWN
Practice Address - State:AL
Practice Address - Zip Code:35023-1657
Practice Address - Country:US
Practice Address - Phone:205-605-8664
Practice Address - Fax:205-377-7439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health