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General NPI Number Information
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NPI Number | 1194238881
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Entity Type | Organization
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Legal Business Name | FRENCH TOWN RESIDENTIAL LLC
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Dates
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Enumeration Date | 11/16/2017
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Last Update Date | 11/16/2017
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Provider Practice Location Address
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Address Line | 1000 AVENUE W.
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City | BIRMINGHAM
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State | AL
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Zip | 35214
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Country | US
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Telephone | 205-777-4588
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Fax | 205-777-4834
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Provider Business Mailing Address
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Address Line | 2218 10TH ST
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City | BIRMINGHAM
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State | AL
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Zip | 35214
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Country | US
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Telephone | 208-777-4588
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Fax | 205-777-4834
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Authorized Official
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Title or Position | CO-OWNER
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Name | MR. SYLVESTER LA SHAWN WALTERS II
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Credential |
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Telephone | 626-318-7997
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State | AL
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