Provider Demographics
NPI:1306123674
Name:CLAUDIAS PLACE INC.
Entity type:Organization
Organization Name:CLAUDIAS PLACE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LUCY
Authorized Official - Middle Name:W
Authorized Official - Last Name:GALLON
Authorized Official - Suffix:
Authorized Official - Credentials:SPECIAL EDUCATIONMED
Authorized Official - Phone:334-312-3034
Mailing Address - Street 1:430 DAMAN DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36108-5410
Mailing Address - Country:US
Mailing Address - Phone:334-312-3034
Mailing Address - Fax:
Practice Address - Street 1:430 DAMAN DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36108-5410
Practice Address - Country:US
Practice Address - Phone:334-312-3034
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health