Provider Demographics
NPI:1023811858
Name:A & A BALM RESIDENTIAL LLC
Entity type:Organization
Organization Name:A & A BALM RESIDENTIAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:POWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-421-9428
Mailing Address - Street 1:PO BOX 92
Mailing Address - Street 2:
Mailing Address - City:SARALAND
Mailing Address - State:AL
Mailing Address - Zip Code:36571-0092
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2162 WAGNER ST
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36617-3025
Practice Address - Country:US
Practice Address - Phone:251-421-9428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities