Organization
MARSHALL JACKSON MENTAL RETARDATION AUTHORITY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANE W EAST (ADMINISTRATIVE ASSISTANT)
(256) 582-7528
Entity
Organization
Contact information
Practice address
2024 GUNTER AVE, GUNTERSVILLE, AL 35976-2113
(256) 582-7528
(256) 582-7311
Mailing address
2024 GUNTER AVE, GUNTERSVILLE, AL 35976-2113
(256) 582-7528
(256) 582-7311
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
09/05/2007
Last updated
09/05/2007
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