Provider Demographics
NPI:1750524476
Name:LITTLE CRF LLC
Entity type:Organization
Organization Name:LITTLE CRF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:LITTLE
Authorized Official - Last Name:H
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-366-9953
Mailing Address - Street 1:PO BOX 70036
Mailing Address - Street 2:LOT 20
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35407-0036
Mailing Address - Country:US
Mailing Address - Phone:205-366-9953
Mailing Address - Fax:205-349-2973
Practice Address - Street 1:5505 JUG FACTORY RD
Practice Address - Street 2:LOT 20
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35405-5265
Practice Address - Country:US
Practice Address - Phone:205-366-9953
Practice Address - Fax:205-349-2973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-10
Last Update Date:2009-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health