Provider Demographics
NPI:1699177295
Name:MORGAN COUNTY SYSTEM OF SERVICES, INC.
Entity Type:Organization
Organization Name:MORGAN COUNTY SYSTEM OF SERVICES, INC.
Other - Org Name:SOS
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SARA
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:256-350-8434
Mailing Address - Street 1:PO BOX 1124
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35602-1124
Mailing Address - Country:US
Mailing Address - Phone:256-350-8434
Mailing Address - Fax:256-350-8534
Practice Address - Street 1:3402 TANGLEWOOD DR SW
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35603-1332
Practice Address - Country:US
Practice Address - Phone:256-350-8434
Practice Address - Fax:256-350-8534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-25
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1194075085Medicaid