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General NPI Number Information
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NPI Number | 1629734397
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Entity Type | Organization
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Legal Business Name | FRUITS OF APPLE TREE, INC
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Dates
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Enumeration Date | 11/16/2021
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Last Update Date | 11/16/2021
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Provider Practice Location Address
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Address Line | 416 19TH ST S
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City | BESSEMER
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State | AL
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Zip | 35020-5864
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Country | US
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Telephone | 770-861-8129
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Fax |
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Provider Business Mailing Address
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Address Line | 27 LATO RD
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City | SEALE
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State | AL
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Zip | 36875-4001
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Country | US
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Telephone | 770-861-8129
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. GARRETT MURRAY JR.
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Credential |
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Telephone | 770-861-8129
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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