Modern Day Living Cerified Residential Facility

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

320900000X Issued in AL

Legal business name

MODERN DAY LIVING CERIFIED RESIDENTIAL FACILITY

Practice address

10761 Old Greensboro Rd
Tuscaloosa, AL 35405-9185

Phone

(205) 792-2891

Fax

(205) 342-1431

NPI assigned

Aug 30, 2010

Last updated

Aug 30, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Maretha Elaine Buffer, NURSE

Title

Executive Director

Phone

(205) 792-2891

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1283126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283126400000",
    "number": "1609182450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10761 OLD GREENSBORO RD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354059185",
            "telephone_number": "205-792-2891",
            "fax_number": "205-342-1431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10761 OLD GREENSBORO RD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354059185",
            "telephone_number": "205-792-2891",
            "fax_number": "205-342-1431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN DAY LIVING CERIFIED RESIDENTIAL FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-30",
        "last_updated": "2010-08-30",
        "status": "A",
        "authorized_official_last_name": "BUFFER",
        "authorized_official_first_name": "MARETHA",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "205-792-2891",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NURSE"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "AL",
            "license": "320900000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caleb A Mixon
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• Stacey Epperson Moffitt, PA
• Shuaib Mohamed, M.D.
• Mark Mohler, M.S., ATC
• Brian M Monroe, PHD, LMFT
• Margaret Anne Monroe, LMFTA

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Tuscaloosa, AL
• Providers in Tuscaloosa, AL by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2010; 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.