Organization
DEKALB COUNTY MR BOARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA WICKS (EXECUTIVE DIRECTOR)
(205) 845-1097
Entity
Organization
Contact information
Practice address
117 FIRST ST NW, FORT PAYNE, AL 35967
(256) 845-1097
Mailing address
117 FIRST ST NW, FORT PAYNE, AL 35967
(256) 845-1097
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
03/16/2007
Last updated
09/11/2025
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