Provider Demographics
NPI:1538405683
Name:R&R GROUPHOMES INC
Entity type:Organization
Organization Name:R&R GROUPHOMES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:P
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-214-1275
Mailing Address - Street 1:1502 FAYE ST SW
Mailing Address - Street 2:1502 FAYE ST SW
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-2731
Mailing Address - Country:US
Mailing Address - Phone:256-214-1275
Mailing Address - Fax:256-340-9353
Practice Address - Street 1:1502 FAYE ST SW
Practice Address - Street 2:1502 FAYE ST SW
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-2731
Practice Address - Country:US
Practice Address - Phone:256-214-1275
Practice Address - Fax:256-340-9353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization