Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X | |||
Community/Behavioral Health |
251S00000X |
| NPI Number | 1790575256 |
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| LBN Legal business name | SOUTHEAST ALABAMA YOUTH SERVICES | ||||
| Authorized official | TABITHA BRANNON - (EXECUTIVE DIRECTOR) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | Yes | ||||
| Enumeration date | 05/08/2025 | ||||
| Last updated | 05/08/2025 - More than a year ago | ||||
| Identifiers |
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