Individual
ROSA COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1508 15TH AVENUE SW, DECATUR, AL 35601-5404
(256) 566-7170
Mailing address
1939 RED SUNSET DRIVE, DECATUR, AL 35603-4481
(256) 566-7170
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
AL
385H00000X
Respite Care
—
AL
Other
Enumeration date
06/28/2024
Last updated
11/24/2024
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