Organization Active NPI

Father Walter Memorial Child Care Center

  • Pediatric Skilled Nursing Facility
  • Montgomery, AL
National Provider Identifier
1336137488
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Skilled Nursing FacilityTaxonomy code 3140N1450X
License
08394 Issued in AL
Legal business name
FATHER WALTER MEMORIAL CHILD CARE CENTER
Practice address
2815 Forbes Dr
Montgomery, AL 36110-1307
Phone
(334) 262-6421
Fax
(334) 262-2265
NPI assigned
Oct 12, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Miss Yataisha Feleese Robertson, RN
Title
Director of Nursing
Phone
(334) 230-1935

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Skilled Nursing Facility 3140N1450X 08394 AL Primary

Addresses

Primary practice location

2815 Forbes Dr
Montgomery, AL 36110-1307

Mailing address

2815 Forbes Dr
Montgomery, AL 36110-1307
Phone (334) 262-6421

Other identifiers 1

IdentifierTypeStateIssuer
4751050SMedicaidAL

National Provider Directory

National Provider Directory
Tax ID family
Father Walter Memorial Child Care Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2815 Forbes Dr
Montgomery, AL 36110
Phone (334) 263-4221

NPI Registry JSON

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336137488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2815 FORBES DR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361101307",
            "telephone_number": "334-262-6421",
            "fax_number": "334-262-2265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 FORBES DR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361101307",
            "telephone_number": "334-262-6421",
            "fax_number": "334-262-2265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FATHER WALTER MEMORIAL CHILD CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "YATAISHA",
        "authorized_official_middle_name": "FELEESE",
        "authorized_official_title_or_position": "DIRECTOR OF NURSING",
        "authorized_official_telephone_number": "334-230-1935",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": "AL",
            "license": "08394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4751050S",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.