Healthcare Provider Details

I. General information

NPI: 1235098336
Provider Name (Legal Business Name): LIZ & LAMAR INDEPENDENT LIVING WITH DISABILITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5330 MOFFETT RD
MOBILE AL
36618-2904
US

IV. Provider business mailing address

5330 MOFFETT RD
MOBILE AL
36618-2904
US

V. Phone/Fax

Practice location:
  • Phone: 850-694-7707
  • Fax:
Mailing address:
  • Phone: 251-487-5182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: TAMMY L CEASOR
Title or Position: OWNER
Credential:
Phone: 251-487-5182