Organization
GATEWAY
Active
Organization
GATEWAY
Active
Other names
FAMILY AND CHILD SERVICES
Organization subpart
No
Provider details
NPI number
Authorized official
MR. E. JAMES LOOP (EXECUTIVE DIRECTOR)
(205) 510-2629
Entity
Organization
Contact information
Practice address
1401 20TH ST S, BIRMINGHAM, AL 35205-4913
(205) 510-2600
(205) 510-2621
Mailing address
1401 SOUTH 20TH STREET SOUTH, BIRMINGHAM, AL 35209
(205) 510-2600
(205) 510-2621
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01200383
BLUE CROSS BLUE SHIELD
AL
01
—
51008153
BLUE CROSS BLUE SHIELD
AL
01
—
62-21208
UNITED BEHAVIORAL HEALTH
AL
Enumeration date
07/31/2006
Last updated
02/14/2008
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