| Southeast Alabama Youth Services, Inc | |
|
76 Victoria St Louisville AL 36048-3525 | |
| (334) 714-2549 | |
| Not Available |
| Full Name | Southeast Alabama Youth Services, Inc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 76 Victoria St, Louisville, Alabama |
| Authorized Official Name and Position | Samantha Danielle Gordon (PROGRAM DIRECTOR) |
| Authorized Official Contact | 3349838377 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Alabama Youth Services, Inc 2856 Horace Shepard Dr Dothan AL 36303-1007 Ph: (334) 714-2549 | Southeast Alabama Youth Services, Inc 76 Victoria St Louisville AL 36048-3525 Ph: (334) 714-2549 |
| NPI Number | 1760100804 |
|---|---|
| Provider Enumeration Date | 08/15/2022 |
| Last Update Date | 08/15/2022 |
| Certification Date | 08/15/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760100804 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
Quest Counseling Agency, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 76 Victoria St, Louisville, AL 36048 Phone: 801-388-1650 |