# SOUTHERN OAKS RESIDENTIAL ACADEMY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southern Oaks Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588650816
- **Authorized official:** MRS. PENNY ANN KAKOLIRIS (EXECUTIVE VICE PRESIDENT)
- **Authorized official phone:** (205) 664-9480

## Contact information

- **Practice address:** 2280 HIGHWAY 35, PELHAM, AL 35124-2189
- **Practice address phone:** (205) 664-3480
- **Practice address fax:** (205) 685-1477
- **Mailing address:** PO BOX 1625, 2280 HIGHWAY 35 SOUTH, PELHAM, AL 35124-5625
- **Mailing address phone:** (205) 664-3480
- **Mailing address fax:** (205) 685-1477

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | AL | Yes |

## Other

- **Enumeration date:** 09/22/2005
- **Last updated:** 08/22/2020