Southeast Alabama Youth Services, INC
Counselor, Professional in Louisville, AL. Organization (NPI-2).
NPI number1760100804
StatusActive
Last updated in NPPESAug 15, 2022
Details
- NPI
- 1760100804
- Entity type
- Organization (NPI-2)
- Legal business name
- Southeast Alabama Youth Services, INC
- Organization subpart
- No
- Enumeration date
- Aug 15, 2022
- Certification date
- Aug 15, 2022
- Last updated
- Aug 15, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | – | – | Yes |
Practice location
76 Victoria StLouisville, AL 36048-3525
Phone 334-714-2549
Mailing address
2856 Horace Shepard DrDothan, AL 36303-1007
Phone 334-714-2549 · Fax 334-983-1289
Authorized official
Samantha Danielle Gordon
Program Director
3349838377
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