Organization
ST. MARY'S HOME
Active
Other names
Archdiocese of Mobile
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILLIP ANDREW WYNNE MSW (ADMININSTRATOR)
(251) 344-7733
Entity
Organization
Contact information
Practice address
4350 MOFFETT RD, MOBILE, AL 36618-1719
(251) 344-7733
(251) 344-9753
Mailing address
4350 MOFFETT RD, MOBILE, AL 36618-1719
(251) 344-7733
(251) 344-9753
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
000228
AL
Other
Enumeration date
08/30/2006
Last updated
08/22/2020
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