Provider Demographics
NPI:1477732584
Name:NOLRAV HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:NOLRAV HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:VARLON
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-264-2914
Mailing Address - Street 1:207 MONTGOMERY ST
Mailing Address - Street 2:SUITE 225
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36104-3541
Mailing Address - Country:US
Mailing Address - Phone:334-264-2914
Mailing Address - Fax:334-264-2916
Practice Address - Street 1:207 MONTGOMERY ST
Practice Address - Street 2:SUITE 225
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36104-3541
Practice Address - Country:US
Practice Address - Phone:334-264-2914
Practice Address - Fax:334-264-2916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services