King Certified Residential Facility

NPI #1497910244 in Northport, Alabama

Provider Information

NPI Number: 1497910244
Entity Type: Organization
Organization Name: King Certified Residential Facility
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Jul 22, 2008
Last Updated: Jul 22, 2008

Practice Location

Address: 4008 FLATWOODS ROAD
City: Northport
State: Alabama
ZIP Code: 35473-1101
Phone: (205) 792-7829

Authorized Official

Name: RENEE KING HOLLEY
Title: FAMILY PROVIDER
Phone: (205) 792-7829

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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