Healthcare Provider Details

I. General information

NPI: 1851536577
Provider Name (Legal Business Name): BURROWES GROUP RESIDENTIAL FACILITIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2008
Last Update Date: 12/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1610 ROACH ST
MOBILE AL
36617-1819
US

IV. Provider business mailing address

PO BOX 40806
MOBILE AL
36640-0806
US

V. Phone/Fax

Practice location:
  • Phone: 251-457-7090
  • Fax:
Mailing address:
  • Phone: 251-457-7090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateAL

VIII. Authorized Official

Name: MRS. STEPHANIE YORK BURROWES
Title or Position: EXECUTIVE DIRECTOR/PROVIDER
Credential: MASTERS IN EDUCATION
Phone: 251-457-7090