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Organization
SEQUEL TSI OF PAINT ROCK VALLEY, LLC
Active
Organization
SEQUEL TSI OF PAINT ROCK VALLEY, LLC
Active
Other names
Paint Rock Valley Boys
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN STUPAK (PRESIDENT)
(267) 419-8913
Entity
Organization
Contact information
Practice address
3890 COUNTY ROAD 20, TRENTON, AL 35774-7423
(256) 776-2503
(256) 776-2561
Mailing address
3890 COUNTY ROAD 20, TRENTON, AL 35774-7423
(256) 776-2503
(256) 776-2561
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
NULL
Other
Enumeration date
01/05/2010
Last updated
01/05/2010
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