Organization
SHOALS COMMITTEE ON PROGRAMS AND EMPLOYMENT FOR THE MENTALLY RETARDED
Active
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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