Mary's Mission & Developmental Center, Inc.

NPI #1336250190 in Hereford, Arizona

Provider Information

NPI Number: 1336250190
Entity Type: Organization
Organization Name: Mary's Mission & Developmental Center, Inc.
Primary Specialty: Residential Treatment Facility, Emotionally Disturbed Children
Enumeration Date: Aug 31, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 8360 S HIGHWAY 92
City: Hereford
State: Arizona
ZIP Code: 85615-9087
Phone: (520) 378-5175

Authorized Official

Name: MR. WILLIAM LACEY, M.B.A.
Title: CEO/ADMINISTRATOR
Phone: (520) 417-2115

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Emotionally Disturbed Children	322D00000X	Primary

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