Healthcare Provider Details

I. General information

NPI: 1699457770
Provider Name (Legal Business Name): ESP ADULT DAY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2023
Last Update Date: 08/07/2023
Certification Date: 08/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

671 STANTON RD
MOBILE AL
36617-2200
US

IV. Provider business mailing address

671 STANTON RD
MOBILE AL
36617-2200
US

V. Phone/Fax

Practice location:
  • Phone: 251-689-5806
  • Fax: 251-456-7146
Mailing address:
  • Phone: 251-689-5806
  • Fax: 251-456-7146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. ELISSA S PARKER
Title or Position: EXECUTIVE DIRECTOR
Credential: MSW, MS ED
Phone: 251-689-5806