Provider Demographics
NPI:1184881955
Name:HOUSTON COUNTY HEALTHCARE AUTHORITY
Entity type:Organization
Organization Name:HOUSTON COUNTY HEALTHCARE AUTHORITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LORENZO
Authorized Official - Middle Name:
Authorized Official - Last Name:SUTER
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, MHA, DHA
Authorized Official - Phone:334-794-0591
Mailing Address - Street 1:1000 W MAIN ST
Mailing Address - Street 2:SUITE 460B
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36301-1447
Mailing Address - Country:US
Mailing Address - Phone:334-794-0591
Mailing Address - Fax:334-793-6073
Practice Address - Street 1:1000 W MAIN ST
Practice Address - Street 2:SUITE 460B
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-1447
Practice Address - Country:US
Practice Address - Phone:334-794-0591
Practice Address - Fax:334-793-6073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-20
Last Update Date:2008-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL017016Medicare Oscar/Certification