Provider Demographics
NPI:1912081100
Name:AUTAUGA-ELMORE MENTAL RETARDATION BOARD, INC.
Entity Type:Organization
Organization Name:AUTAUGA-ELMORE MENTAL RETARDATION BOARD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:WELCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-285-0163
Mailing Address - Street 1:PO BOX 1280
Mailing Address - Street 2:
Mailing Address - City:MILLBROOK
Mailing Address - State:AL
Mailing Address - Zip Code:36054-0028
Mailing Address - Country:US
Mailing Address - Phone:334-285-0163
Mailing Address - Fax:
Practice Address - Street 1:3750 COOSADA RD.
Practice Address - Street 2:
Practice Address - City:MILLBROOK
Practice Address - State:AL
Practice Address - Zip Code:36054
Practice Address - Country:US
Practice Address - Phone:334-285-0163
Practice Address - Fax:334-285-0569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251B00000XAgenciesCase Management
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled Services