Provider Demographics
NPI:1811325962
Name:ALLIANCE COMMUNITY SERVICES, INC
Entity type:Organization
Organization Name:ALLIANCE COMMUNITY SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:POLSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, RN, C N L
Authorized Official - Phone:205-903-1660
Mailing Address - Street 1:636 FOUNDERS PARK DR W
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35226-4143
Mailing Address - Country:US
Mailing Address - Phone:205-588-5722
Mailing Address - Fax:205-942-7660
Practice Address - Street 1:651 BEACON PKWY W
Practice Address - Street 2:SUITE 202B
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-3141
Practice Address - Country:US
Practice Address - Phone:205-588-5722
Practice Address - Fax:205-942-7660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health