Organization
SEQUEL TSI OF PAINT ROCK VALLEY, LLC
Active
Other names
Paint Rock Valley Girls
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN STUPAK (PRESIDENT)
(267) 419-8913
Entity
Organization
Contact information
Practice address
3890 COUNTY ROAD 20, TRENTON, AL 35774-7423
(256) 776-2503
(256) 776-2561
Mailing address
3890 COUNTY ROAD 20, TRENTON, AL 35774-7423
(256) 776-2503
(256) 776-2561
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/27/2010
Last updated
01/27/2010
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