Provider Demographics
NPI:1649325788
Name:COMMUNITY SERVICE PROGRAMS OF WEST ALABAMA INC
Entity type:Organization
Organization Name:COMMUNITY SERVICE PROGRAMS OF WEST ALABAMA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-752-5429
Mailing Address - Street 1:601 17TH ST
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-4807
Mailing Address - Country:US
Mailing Address - Phone:205-752-5429
Mailing Address - Fax:205-752-8653
Practice Address - Street 1:2002 MCFARLAND BLVD E
Practice Address - Street 2:SUITE 209
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404-5805
Practice Address - Country:US
Practice Address - Phone:205-752-0476
Practice Address - Fax:205-752-8122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X
ALPTH24092251P0200X
AL0207225XP0200X
AL2078235Z00000X
AL453235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered251B00000XAgenciesCase ManagementGroup - Single Specialty
Not Answered2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty
Not Answered225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty