Organization
LEE COUNTY YOUTH DEVELOPMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA COOPER (EXECUTIVE DIRECTOR)
(334) 749-2996
Entity
Organization
Contact information
Practice address
1109 SPRING DR, OPELIKA, AL 36801-5345
(334) 749-2996
Mailing address
1109 SPRING DR, OPELIKA, AL 36801-5345
(334) 749-2996
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
671
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1336396399
NPPES
—
01
—
1407003486
NPPES
—
01
—
1427295591
NPPES
—
01
—
1558475319
NPPES
—
01
—
1619368875
NPPES
—
01
—
1861631962
NPPES
—
05
—
339090245
—
AL
05
—
339100001
—
AL
05
—
529804070
—
AL
05
—
RTF0001H
—
AL
Enumeration date
03/31/2016
Last updated
03/31/2016
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