Provider Demographics
NPI:1972019214
Name:RECOVERY ORGANIZATION OF SUPPORT SPECIALIST
Entity Type:Organization
Organization Name:RECOVERY ORGANIZATION OF SUPPORT SPECIALIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:KALLA
Authorized Official - Middle Name:SALTER
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:CRSS
Authorized Official - Phone:205-516-5112
Mailing Address - Street 1:281 W VALLEY AVE
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35209-4817
Mailing Address - Country:US
Mailing Address - Phone:205-848-2112
Mailing Address - Fax:205-848-2114
Practice Address - Street 1:281 W VALLEY AVE
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-4817
Practice Address - Country:US
Practice Address - Phone:205-848-2112
Practice Address - Fax:205-848-2114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-22
Last Update Date:2017-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable