PHP of Alabama

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

480 Issued in AL

Legal business name

PHP OF ALABAMA

Practice address

62 Red Eagle Pkwy
Wetumpka, AL 36092-2052

Phone

(334) 567-3729

Fax

(334) 514-6776

NPI assigned

Jul 22, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Jon Burns

Title

Administrator

Phone

(334) 567-3729

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437159290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 RED EAGLE PKWY",
            "city": "WETUMPKA",
            "state": "AL",
            "postal_code": "360922052",
            "telephone_number": "334-567-3729",
            "fax_number": "334-514-6776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 RED EAGLE PKWY",
            "city": "WETUMPKA",
            "state": "AL",
            "postal_code": "360922052",
            "telephone_number": "334-567-3729",
            "fax_number": "334-514-6776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHP OF ALABAMA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BURNS",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "334-567-3729",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "AL",
            "license": "480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Perfect Pain Solutions, L.L.C.
• Meagan Louise Petrunic
• Van Pham, RPH
• Pharmix RX LLC
• Phoenix Path Counseling, LLC
• PHP of Alabama, Inc.
• Physicians Choice Dialysis of Alabama LLC
• Tisha Powell, RN, IBCLC
• Leslie Susan Powers, MS, LPC
• Prattville S&S, Dba Magnolia Wood Lodge

• Assisted Living Facility (Mental Illness) in Wetumpka, AL
• Providers in Wetumpka, AL by specialty
• Assisted Living Facility (Mental Illness) in Alabama

• 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.