Provider Demographics
NPI:1184893729
Name:CHILDREN'S OF MONTGOMERY, INC.
Entity type:Organization
Organization Name:CHILDREN'S OF MONTGOMERY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MASTER
Authorized Official - Phone:334-262-4850
Mailing Address - Street 1:310 N MADISON TER
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36107-1514
Mailing Address - Country:US
Mailing Address - Phone:334-262-4850
Mailing Address - Fax:334-262-1081
Practice Address - Street 1:310 N MADISON TER
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36107-1514
Practice Address - Country:US
Practice Address - Phone:334-262-4850
Practice Address - Fax:334-262-1081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-28
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251B00000XAgenciesCase Management