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Organization

MARY LEE FOUNDATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. CHARLENE CRUMP (EXECUTIVE DIRECTOR)
(512) 443-1360
Entity
Organization

Contact information

Practice address
1326 LAMAR SQUARE DR, AUSTIN, TX 78704-8970
(512) 443-1360
(512) 443-1758
Mailing address
PO BOX 3174, AUSTIN, TX 78764-3174
(512) 443-1360
(512) 443-1758

Taxonomy

Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
120677
TX

Other

Enumeration date
11/20/2007
Last updated
11/20/2007
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