Organization
SHOALS COMMITTEE ON PROGRAMS AND EMPLOYMENT FOR THE MENTALLY RETARDED
Active
Other names
SCOPE 310 Authority
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ARVY G DUPUY III (EXECUTIVE DIRECTOR)
(256) 768-0901
Entity
Organization
Contact information
Practice address
4129 HELTON DR, FLORENCE, AL 35630-6207
(256) 768-0901
Mailing address
4129 HELTON DR, FLORENCE, AL 35630-6207
(256) 768-0901
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
0961B
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194905687
—
AL
Enumeration date
10/14/2016
Last updated
10/14/2016
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