Provider Demographics
NPI:1255444584
Name:CHILDREN'S VILLAGE
Entity type:Organization
Organization Name:CHILDREN'S VILLAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:SONYA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:BSW
Authorized Official - Phone:205-925-0074
Mailing Address - Street 1:2001 18TH ST SW
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35211-5402
Mailing Address - Country:US
Mailing Address - Phone:205-925-0074
Mailing Address - Fax:205-925-1118
Practice Address - Street 1:2001 18TH ST SW
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-5402
Practice Address - Country:US
Practice Address - Phone:205-925-0074
Practice Address - Fax:205-925-1118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL322D00000X322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children