Organization
KING CERTIFIED RESIDENTIAL FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENEE KING HOLLEY (FAMILY PROVIDER)
(205) 792-7829
Entity
Organization
Contact information
Practice address
4008 FLATWOODS ROAD, NORTHPORT, AL 35473-1101
(205) 792-7829
Mailing address
4008 FLATWOODS RD, NORTHPORT, AL 35473-1101
(205) 792-7829
(205) 330-1359
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
5324343
AL
Other
Enumeration date
07/22/2008
Last updated
07/22/2008
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