Organization
MARY'S MISSION & DEVELOPMENTAL CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM LACEY JR. MBA (CEO/ADMINISTRATOR)
(520) 417-2115
Entity
Organization
Contact information
Practice address
345 TAYLOR DR, SIERRA VISTA, AZ 85635-3801
(520) 417-2115
(520) 417-2114
Mailing address
345 TAYLOR DR, SIERRA VISTA, AZ 85635-3801
(520) 417-2115
(520) 417-2114
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
BH-1422
AZ
Other
Enumeration date
08/31/2006
Last updated
08/22/2020
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