Organization
MARY'S MISSION AND DEVELOPMENTAL CENTER
Active
Other names
Mary's Mission Outpatient Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM LACEY (CEO)
(480) 844-0022
Entity
Organization
Contact information
Practice address
736 N COUNTRY CLUB DR, MESA, AZ 85201-4936
(480) 844-0011
Mailing address
736 N COUNTRY CLUB DR, MESA, AZ 85201-4936
(480) 844-0011
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
BH-3732
AZ
Other
Enumeration date
12/23/2010
Last updated
12/23/2010
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