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Organization
MONTELISSA FULL LIFE RESOURCES, INC
Active
Organization
MONTELISSA FULL LIFE RESOURCES, INC
Active
Other names
Montelissa Residential
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DENISE JOHNSON MASON (CEO)
(256) 345-3996
Entity
Organization
Contact information
Practice address
1008 CLARKVIEW ST SW, DECATUR, AL 35601-6204
(256) 686-1411
Mailing address
1008 CLARKVIEW ST SW, DECATUR, AL 35601-6204
(256) 686-1411
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
NULL
Other
Enumeration date
12/15/2012
Last updated
12/15/2012
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