Organization
RENAISSANCE RESIDENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GWENDOLYN TRENESE-WILLIAMS JONES ED.S (DIRECTOR)
(251) 621-3525
Entity
Organization
Contact information
Practice address
1947 SUMMER PLACE DR W, MOBILE, AL 36618-3237
(251) 300-4207
Mailing address
11673 MCFARLAND RD, SPANISH FORT, AL 36527-5768
(251) 621-3525
(251) 621-3525
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
11/04/2009
Last updated
11/04/2009
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