Provider Demographics
NPI:1881867893
Name:ALABAMA BAPTIST CHILDREN'S HOME
Entity Type:Organization
Organization Name:ALABAMA BAPTIST CHILDREN'S HOME
Other - Org Name:PATHWAY PROFESSIONAL COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROD
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-945-0037
Mailing Address - Street 1:1305 MCMILLAN AVE
Mailing Address - Street 2:
Mailing Address - City:BREWTON
Mailing Address - State:AL
Mailing Address - Zip Code:36426-1324
Mailing Address - Country:US
Mailing Address - Phone:251-809-3191
Mailing Address - Fax:251-809-8215
Practice Address - Street 1:1305 MCMILLAN AVE
Practice Address - Street 2:
Practice Address - City:BREWTON
Practice Address - State:AL
Practice Address - Zip Code:36426-2957
Practice Address - Country:US
Practice Address - Phone:251-809-3191
Practice Address - Fax:251-809-8215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-10
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALLMFT L224251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health