Provider Demographics
NPI:1760529721
Name:ALABAMA DEPARTMENT OF REHABILITATION SERVICES
Entity Type:Organization
Organization Name:ALABAMA DEPARTMENT OF REHABILITATION SERVICES
Other - Org Name:CHILDREN'S REHABILITATION SERVICE
Other - Org Type:Other Name
Authorized Official - Title/Position:COMMISSIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:SHIVERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-613-2200
Mailing Address - Street 1:2129 E SOUTH BLVD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-2409
Mailing Address - Country:US
Mailing Address - Phone:334-613-2200
Mailing Address - Fax:334-613-1973
Practice Address - Street 1:2129 E SOUTH BLVD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2409
Practice Address - Country:US
Practice Address - Phone:334-613-2200
Practice Address - Fax:334-613-1973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-18210OtherNUTRITION
AL515-18212OtherOPTHALMOLOGY
AL515-18214OtherORTHOPEDICS
AL515-18220OtherPSYCHIATRY-PSYCHOLOGY
AL515-18213OtherORAL MAXILOFACIAL
AL515-18224OtherSOCIAL WORKER
AL515-18215OtherOTOLARYNGOLOGY
AL515-18225OtherSPEECH THERAPY
AL515-18209OtherNURSE PRACTITIONER
AL515-18219OtherPLASTIC SURGERY
AL515-18222OtherPULMONARY
AL515-18207OtherNEPHROLOGY
AL515-18208OtherNEUROLOGY
AL515-18211OtherOCCUPATIONAL THERAPY
AL515-18218OtherPHYSICAL THERAPY
AL515-18221OtherRADIOLOGY
AL515-18216OtherPEDIATRICS
AL515-18217OtherPHYSICAL MEDICINE
AL515-18223OtherRHEUMATOLOGY
AL515-18226OtherUROLOGY