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Organization
ST. MARY'S HOME
Active
Organization
ST. MARY'S HOME
Active
Other names
Archdiocese of Mobile
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILLIP ANDREW WYNNE MSW (ADMININSTRATOR)
(251) 344-7733
Entity
Organization
Contact information
Practice address
4350 MOFFETT RD, MOBILE, AL 36618-1719
(251) 344-7733
(251) 344-9753
Mailing address
4350 MOFFETT RD, MOBILE, AL 36618-1719
(251) 344-7733
(251) 344-9753
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
000228
AL
Other
Enumeration date
08/30/2006
Last updated
08/22/2020
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