Organization
MARY'S MISSION AND DEVELOPMENTAL CENTER
Active
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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