Provider Demographics
NPI:1134204555
Name:ASSOCIATION FOR RETARDED CITIZENS INC OF JEFFERSON COUNTY
Entity type:Organization
Organization Name:ASSOCIATION FOR RETARDED CITIZENS INC OF JEFFERSON COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-503-4040
Mailing Address - Street 1:215 21ST AVE S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-6801
Mailing Address - Country:US
Mailing Address - Phone:205-323-6383
Mailing Address - Fax:205-323-0085
Practice Address - Street 1:215 21ST AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-6801
Practice Address - Country:US
Practice Address - Phone:205-323-6383
Practice Address - Fax:205-323-0085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL591300000Medicaid