Greater Alabama 310 Board

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

GREATER ALABAMA 310 BOARD

Practice address

117 Gemini Circle
Suite 407
Birmingham, AL 35209

Phone

(205) 945-9310

Fax

(205) 945-8527

NPI assigned

Oct 18, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Kendra Eidson

Title

Executive Director

Phone

(205) 945-9310

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jefferson County Intellectual & Developmental Disabilities Other name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706227200000",
    "number": "1063593986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 GEMINI CIRCLE",
            "address_2": "SUITE 407",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35209",
            "telephone_number": "205-945-9310",
            "fax_number": "205-945-8527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 GEMINI CIRCLE",
            "address_2": "SUITE 407",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35209",
            "telephone_number": "205-945-9310",
            "fax_number": "205-945-8527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER ALABAMA 310 BOARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2024-01-26",
        "status": "A",
        "authorized_official_last_name": "EIDSON",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "205-945-9310",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "591500033",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jefferson County Intellectual & Developmental Disabilities",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Case Management Agency in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Case Management Agency in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.