Organization
MODERN DAY LIVING CERIFIED RESIDENTIAL FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARETHA ELAINE BUFFER NURSE (EXECUTIVE DIRECTOR)
(205) 792-2891
Entity
Organization
Contact information
Practice address
10761 OLD GREENSBORO RD, TUSCALOOSA, AL 35405-9185
(205) 792-2891
(205) 342-1431
Mailing address
10761 OLD GREENSBORO RD, TUSCALOOSA, AL 35405-9185
(205) 792-2891
(205) 342-1431
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
320900000X
AL
Other
Enumeration date
08/30/2010
Last updated
08/30/2010
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