Provider Demographics
NPI:1851463269
Name:CULLMAN COUNTY CENTER FOR THE DEVELOPMENTALLY DISABLED, INC.
Entity Type:Organization
Organization Name:CULLMAN COUNTY CENTER FOR THE DEVELOPMENTALLY DISABLED, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING CLERK
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-737-1915
Mailing Address - Street 1:1807 BEECH AVE SE
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-5462
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1807 BEECH AVE SE
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-5462
Practice Address - Country:US
Practice Address - Phone:256-737-1915
Practice Address - Fax:256-734-3231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH1597225100000X
ALPTH3944225100000X
ALOTO266225X00000X
AL1449235Z00000X
251B00000X, 251C00000X, 320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Not Answered251B00000XAgenciesCase ManagementGroup - Multi-Specialty
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Multi-Specialty
Not Answered320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesGroup - Multi-Specialty