Provider Demographics
NPI:1619179520
Name:NORTHWEST ALABAMA TREATMENT CENTER
Entity Type:Organization
Organization Name:NORTHWEST ALABAMA TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:BEELER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-572-4357
Mailing Address - Street 1:4204 EDMONTON DR
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35022-4878
Mailing Address - Country:US
Mailing Address - Phone:205-425-1200
Mailing Address - Fax:205-425-9606
Practice Address - Street 1:4204 EDMONTON DR
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35022-4878
Practice Address - Country:US
Practice Address - Phone:205-425-1200
Practice Address - Fax:205-425-9606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-03
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL110992324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility