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Contact Information

SOUTHEAST ALABAMA YOUTH SERVICES
2856 HORACE SHEPARD DR.
DOTHAN, AL36303
 Phone: 334-983-8377
 Fax: 334-983-1289
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Professional

101YP2500X
 

Community/Behavioral Health

251S00000X
Indicates primary specialty

NPI Profile & details for SOUTHEAST ALABAMA YOUTH SERVICES · (Female)

NPI Number 1790575256
Status Active
Credentials
Entity Individual
Enumeration date 05/08/2025
Last updated 05/08/2025 - More than a year ago
Sole proprietor 1 Not specified
Identifiers
  • AL Medicaid 339100015
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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