NPI 1063758282

Montelissa Full Life Resources, INC

Organisation Exclusive Provider Organization Decatur, AL

Practice location

Address: 1008 Clarkview St SW, Decatur, AL 35601-6204
Phone: (256) 686-1411

Authorised official

Name: Denise Johnson Mason
Title: Ceo
Phone: (256) 345-3996

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X

Other Exclusive Provider Organization providers in Alabama →

Registry record

NPI: 1063758282
Entity type: Organization
NPI issued: 15 Dec 2012
Record last updated: 15 Dec 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.