Provider Demographics
NPI:1760189278
Name:WALKS OF LIFE, LLC
Entity Type:Organization
Organization Name:WALKS OF LIFE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:RANDI
Authorized Official - Middle Name:YVETTE
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:ALC
Authorized Official - Phone:205-520-4303
Mailing Address - Street 1:901 19TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:CENTER POINT
Mailing Address - State:AL
Mailing Address - Zip Code:35215-4226
Mailing Address - Country:US
Mailing Address - Phone:205-520-4303
Mailing Address - Fax:
Practice Address - Street 1:105 VULCAN RD
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-4701
Practice Address - Country:US
Practice Address - Phone:205-520-4303
Practice Address - Fax:888-212-0844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-14
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health