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Individual

MR. ELDRIDGE BLAKE BAKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
153 LEE ROAD 697, OPELIKA, AL 36804-0443
(334) 663-1561
Mailing address
153 LEE ROAD 697, OPELIKA, AL 36804-0443
(334) 663-1561

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
385H00000X
Respite Care
Primary
385HR2050X
Respite Care Camp
385HR2055X
Child Mental Illness Respite Care
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
385HR2065X
Child Physical Disabilities Respite Care

Other

Enumeration date
07/24/2018
Last updated
07/24/2018
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