Organization
HANDICAPPED ENVIROMENTAL LIVING PROGRAM, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAMELA T. KNOX (BOOKKEEPER)
(334) 230-1945
Entity
Organization
Contact information
Practice address
2820 MILTON RD, MONTGOMERY, AL 36110-1312
(334) 269-5762
(334) 269-5709
Mailing address
2820 MILTON RD, MONTGOMERY, AL 36110-1312
(334) 269-5762
(334) 269-5709
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
251S00000X
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8464000
MEDICAID PROVIDER NUMBER
AL
Enumeration date
10/30/2007
Last updated
10/30/2007
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