Provider Demographics
NPI:1720115074
Name:THE ENRICHMENT CENTER, INC
Entity Type:Organization
Organization Name:THE ENRICHMENT CENTER, INC
Other - Org Name:THE ENRICHMENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:LITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC
Authorized Official - Phone:256-341-0811
Mailing Address - Street 1:224 2ND AVE SE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-2344
Mailing Address - Country:US
Mailing Address - Phone:256-341-0811
Mailing Address - Fax:256-341-9358
Practice Address - Street 1:224 2ND AVE SE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-2344
Practice Address - Country:US
Practice Address - Phone:256-341-0811
Practice Address - Fax:256-341-9358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1514101YP2500X
AL2162101YP2500X
AL1985101YP2500X
ALC834A101YP2500X
AL1076101YP2500X
ALC1145A101YP2500X
AL1597C1041C0700X
ALL267106H00000X
ALS144106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL491954Medicare UPIN
AL558326Medicare UPIN
AL491952Medicare UPIN
AL556124Medicare UPIN
AL515-30621Medicare UPIN
AL515-28347Medicare UPIN
AL515-10440Medicare UPIN
AL515-10442Medicare UPIN
AL515-29274Medicare UPIN