1073591236 NPI number — UNITED STATES HEALTH & HOUSING FOUNDATION, INC

Table of content: (NPI 1073591236)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073591236 NPI number — UNITED STATES HEALTH & HOUSING FOUNDATION, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNITED STATES HEALTH & HOUSING FOUNDATION, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
OAKVIEW HEALTH CARE CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1073591236
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/23/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
929 MIXON SCHOOL ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OZARK
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36360-6174
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
334-774-2631
Provider Business Mailing Address Fax Number:
334-774-4252

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
929 MIXON SCHOOL ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OZARK
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36360-6174
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-774-2631
Provider Business Practice Location Address Fax Number:
334-774-4252
Provider Enumeration Date:
01/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ROBERTS
Authorized Official First Name:
JUDY
Authorized Official Middle Name:
SHERRY
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
334-774-2631

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  10509 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 010577 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 4754180S , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".




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