Provider Demographics
NPI:1871370783
Name:S & L RESIDENTIAL LLC
Entity type:Organization
Organization Name:S & L RESIDENTIAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:S
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-217-4748
Mailing Address - Street 1:2860 DAUPHIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-2415
Mailing Address - Country:US
Mailing Address - Phone:251-217-4748
Mailing Address - Fax:
Practice Address - Street 1:3574 KINGS GATE DR W
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36618-4699
Practice Address - Country:US
Practice Address - Phone:251-217-4748
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:S & L RESIDENTIAL LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities