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Organization

PHP OF ALABAMA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JON BURNS (ADMINISTRATOR)
(334) 567-3729
Entity
Organization

Contact information

Practice address
62 RED EAGLE PKWY, WETUMPKA, AL 36092-2052
(334) 567-3729
(334) 514-6776
Mailing address
62 RED EAGLE PKWY, WETUMPKA, AL 36092-2052
(334) 567-3729
(334) 514-6776

Taxonomy

Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
480
AL

Other

Enumeration date
07/22/2005
Last updated
08/22/2020
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