| Colonial Haven Rehab | |
|
616 Armory St Greensboro AL 36744-2110 | |
| (334) 624-3360 | |
| Not Available |
| Full Name | Colonial Haven Rehab |
|---|---|
| Speciality | Social Worker |
| Location | 616 Armory St, Greensboro, Alabama |
| Authorized Official Name and Position | Debbie White (ACCOUNTS PAYABLE) |
| Authorized Official Contact | 6012763909 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Colonial Haven Rehab 4109 Highway 98 W Summit MS 39666-9132 Ph: () - | Colonial Haven Rehab 616 Armory St Greensboro AL 36744-2110 Ph: (334) 624-3360 |
| NPI Number | 1083903298 |
|---|---|
| Provider Enumeration Date | 03/29/2011 |
| Last Update Date | 03/29/2011 |
| Medicare PECOS PAC ID | 7911181805 |
|---|---|
| Medicare Enrollment ID | O20110419000203 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083903298 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Paul G Larussa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861580672 PECOS PAC ID: 4880754175 Enrollment ID: I20081117000315 |
| Provider Name | David Ward Hodo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487681672 PECOS PAC ID: 1456476571 Enrollment ID: I20100914000076 |
John A. Dorsey, M.d., P.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 745 Horse Shoe Bnd, Greensboro, AL 36744 Phone: 334-624-0472 |