Dekalb County Mr Board in Fort Payne - Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities
Dekalb County Mr Board - NPI 1720112014
Dekalb County Mr Board is a Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities in Fort Payne, Alabama. Dekalb County Mr Board practices all healthcare services and medical treatments related to Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities. The NPI Number for Dekalb County Mr Board is 1720112014. The last update date is 2020-08-22.
Dekalb County Mr Board's current location address is 117 First St Nw, Fort Payne, Alabama. You can contact this provider via phone number 2568451097. The mailing address for Dekalb County Mr Board is 117 First St Nw, Fort Payne, Alabama. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Dekalb County Mr Board |
|---|---|
| Address | 117 First St Nw, Fort Payne, Alabama |
| Phone Number | 2568451097 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | EXECUTIVE |
|---|---|
| Authorized Official Name | Wicks Amanda |
| Telephone Number | 2058451097 |
NPI Number Detail
| NPI Number | 1720112014 |
|---|---|
| Provider Enumeration Date | 2007-03-16 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 117 First St Nw |
|---|---|
| City | Fort Payne |
| State | Alabama (AL) |
| Post Code | 35967 |
| Phone Number | 2568451097 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities |
|---|---|
| Taxonomy | 320900000X |
|
Definition: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities. |
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What is the unique identifier code issued to Dekalb County Mr Board by the Centers for Medicare & Medicaid Services?
The Dekalb County Mr Board has been assigned the NPI (National Provider Identifier) 1720112014. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Dekalb County Mr Board?
The Dekalb County Mr Board is physically situated at 117 First St Nw, in the city of Fort Payne, state of AL, with the postal code 35967.
What is the Dekalb County Mr Board's specialty and taxonomy code?
The Dekalb County Mr Board's specialty is Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities, and the corresponding taxonomy code is 320900000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1720112014 to Dekalb County Mr Board?
The Centers for Medicare & Medicaid Services originally issued the 1720112014 to Dekalb County Mr Board on 2007-03-16.
When was the information regarding Dekalb County Mr Board, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Dekalb County Mr Board, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2020-08-22.
NPI Number: 1124025044
Address: 9244 W Atlantic Blvd Apt 1238, Coral Springs, FL