Provider Demographics
NPI:1932112877
Name:SERAAJ FAMILY HOMES, INC,
Entity Type:Organization
Organization Name:SERAAJ FAMILY HOMES, INC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ABDUL
Authorized Official - Middle Name:S
Authorized Official - Last Name:SERAAJ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-271-2402
Mailing Address - Street 1:PO BOX 230550
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36123-0550
Mailing Address - Country:US
Mailing Address - Phone:334-271-2402
Mailing Address - Fax:334-271-2405
Practice Address - Street 1:400 COTTON GIN RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-3557
Practice Address - Country:US
Practice Address - Phone:334-271-2402
Practice Address - Fax:334-271-2405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL022587322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children