Provider Demographics
NPI:1568541787
Name:JEFFERSON COUNTY COMMITTEE FOR ECONOMIC OPPORTUNITY
Entity Type:Organization
Organization Name:JEFFERSON COUNTY COMMITTEE FOR ECONOMIC OPPORTUNITY
Other - Org Name:JCCEO
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PROGRAM CLINICAL COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNNEICE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:205-787-3040
Mailing Address - Street 1:300 8TH AVE W
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35204-3039
Mailing Address - Country:US
Mailing Address - Phone:205-327-7500
Mailing Address - Fax:205-326-4179
Practice Address - Street 1:228 2ND AVE N
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35204-4709
Practice Address - Country:US
Practice Address - Phone:205-787-3040
Practice Address - Fax:205-783-6542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility