Provider Demographics
NPI:1952056434
Name:MIDDLE ALABAMA AREA AGENCY ON AGING
Entity Type:Organization
Organization Name:MIDDLE ALABAMA AREA AGENCY ON AGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:GAIL
Authorized Official - Last Name:FORTNER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, JD, CRS-A/D
Authorized Official - Phone:205-670-5770
Mailing Address - Street 1:P.O. DRAWER 618
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:AL
Mailing Address - Zip Code:35137-0618
Mailing Address - Country:US
Mailing Address - Phone:205-670-5770
Mailing Address - Fax:205-670-5750
Practice Address - Street 1:209 CLOVERDALE CIR
Practice Address - Street 2:
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-4652
Practice Address - Country:US
Practice Address - Phone:205-670-5770
Practice Address - Fax:205-670-5750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-14
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management