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General NPI Number Information
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NPI Number | 1730999335
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Entity Type | Organization
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Legal Business Name | LOLA MAE'S HOUSE OF HOPE
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Dates
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Enumeration Date | 01/08/2025
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 602 BEL AIR BLVD STE 17
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City | MOBILE
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State | AL
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Zip | 36606-3502
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Country | US
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Telephone | 251-307-4001
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Fax |
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Provider Business Mailing Address
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Address Line | 602 BEL AIR BLVD STE 17
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City | MOBILE
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State | AL
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Zip | 36606-3502
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Country | US
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Telephone | 678-382-8554
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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 | MONICA MINNEFIELD
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Credential |
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Telephone | 251-307-4001
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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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