Doug    DeLoach    OTR
Contract Details
ATI Holdings of Alabama, LLC
Facility name
Provider ID
P000008689
NPI
1346284007
Tax ID
352585937
Effective Date
4/18/2017
Last Updated
4/26/2017
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
75.00
Location Details
Address
76359 Highway 77
Lincoln, AL 35096
United States
County
Talladega
Phone
2563417120 (Phone)
Billing Details
Address
P.O. Box 74008705
Chicago, IL 60674
Billing Phone
6302962222
Specialty Type
Occupational Therapy
Map
Address