NPI 1356678858

Renaissance Residency

Organisation Exclusive Provider Organization Mobile, AL

Practice location

Address: 1947 Summer Place Dr W, Mobile, AL 36618-3237
Phone: (251) 300-4207
Mailing address: 11673 McFarland Rd, Spanish Fort, AL 36527-5768

Authorised official

Name: Gwendolyn Trenese-Williams Jones
Title: Director
Phone: (251) 621-3525

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X

Other Exclusive Provider Organization providers in Alabama →

Registry record

NPI: 1356678858
Entity type: Organization
NPI issued: 4 Nov 2009
Record last updated: 4 Nov 2009

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.