NPIMap

Organization Active NPI

Brewer Porch Children's Center

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Tuscaloosa, AL
National Provider Identifier
1508823956
Registry record updated Aug 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
BREWER PORCH CHILDREN'S CENTER
Practice address
2501 Woodland Rd
Tuscaloosa, AL 35404-5028
Phone
(205) 348-7236
Fax
(205) 348-9368
NPI assigned
Apr 28, 2006
Last updated
Aug 18, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
UNIVERSITY OF ALABAMAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 18, 2015

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

Authorized official

Name
Dr. James William Thompson, PH.D.
Title
Executive Director
Phone
(205) 348-9340

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X NU Primary

Addresses

Primary practice location

2501 Woodland Rd
Tuscaloosa, AL 35404-5028

Mailing address

2501 Woodland Road
Tuscaloosa, AL 35405
Phone (205) 348-7236

Other identifiers 7

IdentifierTypeStateIssuer
330000027MedicaidAL
8400922OtherALUNITED BEHAVIORAL HEALTH
RTF0009HMedicaidAL
339091603MedicaidAL
339091703MedicaidAL
8400921OtherALUNITED BEHAVIORAL HEALTH
330099027MedicaidAL

National Provider Directory

National Provider Directory
Tax ID family
K Williams CRNP12 organizations share this tax ID, including this one
Part of
K Williams CRNP

Other organizations with this tax ID 11

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

NPI Registry JSON

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439856000000",
    "number": "1508823956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 WOODLAND ROAD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "35405",
            "telephone_number": "205-348-7236",
            "fax_number": "205-348-9368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 WOODLAND RD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354045028",
            "telephone_number": "205-348-7236",
            "fax_number": "205-348-9368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREWER PORCH CHILDREN'S CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF ALABAMA",
        "enumeration_date": "2006-04-28",
        "last_updated": "2015-08-18",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "205-348-9340",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "330000027",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL HEALTH",
            "identifier": "8400922",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RTF0009H",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "339091603",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "339091703",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL HEALTH",
            "identifier": "8400921",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "330099027",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2015; 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.