PHP of Alabama, Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

PHP OF ALABAMA, INC.

Practice address

62 Red Eagle Pkwy
Wetumpka, AL 36092-2052

Phone

(334) 567-3729

Fax

(334) 514-6776

NPI assigned

Jan 31, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Wayne T Addison

Title

Controller

Phone

(901) 692-5555

Specialties & licenses 1

Addresses

Tax ID family

PHP of Alabama2 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.

• PHP of Alabama

  • Exclusive Provider Organization
  • Birmingham, AL
  • NPI 1013916725
  NPD tax ID

Locations

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467599282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "468 HALLE PARK DR",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380177089",
            "telephone_number": "901-692-5555",
            "fax_number": "901-692-5561"
        },
        {
            "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, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ADDISON",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "901-692-5555",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meagan Louise Petrunic
• Van Pham, RPH
• Pharmix RX LLC
• Phoenix Path Counseling, LLC
• PHP of Alabama
• Physicians Choice Dialysis of Alabama LLC
• Tisha Powell, RN, IBCLC
• Leslie Susan Powers, MS, LPC
• Prattville S&S, Dba Magnolia Wood Lodge
• Preferred Psych Associates

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Wetumpka, AL
• Providers in Wetumpka, AL by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility 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.