Organization
MARYLILHOMECAREANDGIRLSCLUB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JACQUELINE MARRIETTA JACKSON-JAMES (OWNER)
(334) 922-9489
Entity
Organization
Contact information
Practice address
1041 PERRY HILL RD, MONTGOMERY, AL 36109-4500
(334) 922-9489
Mailing address
2932 BREVARD AVE, MONTGOMERY, AL 36109-2135
(973) 220-2875
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
06/06/2023
Last updated
06/06/2023
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