Provider Demographics
NPI:1427414424
Name:WEST ALABAMA REGIONAL COMMISSION
Entity Type:Organization
Organization Name:WEST ALABAMA REGIONAL COMMISSION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-333-2990
Mailing Address - Street 1:PO BOX 509
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35476-0509
Mailing Address - Country:US
Mailing Address - Phone:205-333-2990
Mailing Address - Fax:205-333-2713
Practice Address - Street 1:4200 HIGHWAY 69 N
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35473-3504
Practice Address - Country:US
Practice Address - Phone:205-333-2990
Practice Address - Fax:205-333-2713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-06
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251X00000XAgenciesSupports Brokerage
No253Z00000XAgenciesIn Home Supportive Care