Organization
SOUTHEAST ALABAMA YOUTH SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERALD H LOVE (EXECUTIVE DIRECTOR)
(334) 983-8377
Entity
Organization
Contact information
Practice address
2856 HORACE SHEPARD DR, DOTHAN, AL 36303-1007
(334) 983-8377
(334) 983-1289
Mailing address
2856 HORACE SHEPARD DR, DOTHAN, AL 36303-1007
(334) 983-8377
(334) 983-1289
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/20/2006
Last updated
08/22/2020
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