Provider Demographics
NPI:1619147006
Name:RANDOLPH COUNTY LEARNING CENTER
Entity Type:Organization
Organization Name:RANDOLPH COUNTY LEARNING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:EVERETT
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-863-8991
Mailing Address - Street 1:PO BOX 127
Mailing Address - Street 2:1475 MAIN STREET
Mailing Address - City:ROANOKE
Mailing Address - State:AL
Mailing Address - Zip Code:36274-0127
Mailing Address - Country:US
Mailing Address - Phone:334-863-8991
Mailing Address - Fax:
Practice Address - Street 1:1475 MAIN STREET
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:AL
Practice Address - Zip Code:36274-0127
Practice Address - Country:US
Practice Address - Phone:334-863-8991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services