Provider Demographics
NPI:1902461643
Name:ALABAMA CARE NETWORK SOUTHEAST
Entity Type:Organization
Organization Name:ALABAMA CARE NETWORK SOUTHEAST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:VELASCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-296-5246
Mailing Address - Street 1:417 20TH ST N STE 1100
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35203-3216
Mailing Address - Country:US
Mailing Address - Phone:205-558-7641
Mailing Address - Fax:
Practice Address - Street 1:1445 S COLLEGE ST STE 300
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36832-5904
Practice Address - Country:US
Practice Address - Phone:334-466-4604
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-08
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management