Provider Demographics
NPI:1073653432
Name:MOBILE ASSOCIATION FOR RETARDED CITIZENS, INC.
Entity Type:Organization
Organization Name:MOBILE ASSOCIATION FOR RETARDED CITIZENS, INC.
Other - Org Name:M.A.R.C.
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:ZOGHBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-665-9626
Mailing Address - Street 1:2424 GORDON SMITH DR
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36617-2319
Mailing Address - Country:US
Mailing Address - Phone:251-479-7409
Mailing Address - Fax:251-473-7649
Practice Address - Street 1:2424 GORDON SMITH DR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36617-2319
Practice Address - Country:US
Practice Address - Phone:251-479-7409
Practice Address - Fax:251-473-7649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL251C00000X, 251J00000X, 320900000X, 347C00000X, 385HR2060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251J00000XAgenciesNursing Care
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No347C00000XTransportation ServicesPrivate Vehicle
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child