Provider Demographics
NPI:1992090666
Name:ROBINSON'S RESIDENTIAL, INC.
Entity type:Organization
Organization Name:ROBINSON'S RESIDENTIAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:251-458-5164
Mailing Address - Street 1:2159 MIMOSA DR
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36617-2681
Mailing Address - Country:US
Mailing Address - Phone:251-458-5164
Mailing Address - Fax:251-456-2467
Practice Address - Street 1:4954 RINGOLD DR S
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36693-3678
Practice Address - Country:US
Practice Address - Phone:251-458-5164
Practice Address - Fax:251-456-2467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-10
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL008301620Medicaid