Provider Demographics
NPI:1154428423
Name:VOLUNTEERS OF AMERICA NORTH ALABAMA, INC
Entity type:Organization
Organization Name:VOLUNTEERS OF AMERICA NORTH ALABAMA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:TUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-830-2155
Mailing Address - Street 1:555 SPARKMAN DR NW
Mailing Address - Street 2:SUITE 454
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35816-3418
Mailing Address - Country:US
Mailing Address - Phone:256-830-2155
Mailing Address - Fax:256-830-2158
Practice Address - Street 1:555 SPARKMAN DR NW
Practice Address - Street 2:SUITE 454
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35816-3418
Practice Address - Country:US
Practice Address - Phone:256-830-2155
Practice Address - Fax:256-830-2158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL4957780IMedicaid
AL4957790IMedicaid