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Organization

FANCY HOMES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MOHAMMAD ABDALLAH LATAYFA (OWNER)
(318) 990-9225
Entity
Organization

Contact information

Practice address
3757 SEASIDE SPARROW CIR, BESSEMER, AL 35022-4719
(318) 990-9225
Mailing address
103 GARDEN VIEW LN APT 103, HOOVER, AL 35244-1841
(318) 990-9225

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary

Other

Enumeration date
09/05/2025
Last updated
09/05/2025
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