Provider Demographics
NPI:1831361773
Name:ALABAMA DEPARTMENT OF YOUTH SERVICES
Entity type:Organization
Organization Name:ALABAMA DEPARTMENT OF YOUTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR OF DYS FEDERAL PROGRAMS
Authorized Official - Prefix:MS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:LGSW
Authorized Official - Phone:334-215-3846
Mailing Address - Street 1:PO BOX 66
Mailing Address - Street 2:
Mailing Address - City:MOUNT MEIGS
Mailing Address - State:AL
Mailing Address - Zip Code:36057-0066
Mailing Address - Country:US
Mailing Address - Phone:334-215-3846
Mailing Address - Fax:334-215-3011
Practice Address - Street 1:1000 INDUSTRIAL SCHOOL ROAD
Practice Address - Street 2:
Practice Address - City:MOUNT MEIGS
Practice Address - State:AL
Practice Address - Zip Code:36057-0066
Practice Address - Country:US
Practice Address - Phone:334-215-3846
Practice Address - Fax:334-215-3011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health