Montelissa Full Life Resources, Inc

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

MONTELISSA FULL LIFE RESOURCES, INC

Practice address

1008 Clarkview St SW
Decatur, AL 35601-6204

Phone

(256) 686-1411

NPI assigned

Dec 15, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Denise Johnson Mason

Title

Ceo

Phone

(256) 345-3996

Specialties & licenses 1

Addresses

Other names 1

• Montelissa Residential Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1355529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355529600000",
    "number": "1063758282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 CLARKVIEW ST SW",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356016204",
            "telephone_number": "256-686-1411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 CLARKVIEW ST SW",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356016204",
            "telephone_number": "256-686-1411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTELISSA FULL LIFE RESOURCES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-15",
        "last_updated": "2012-12-15",
        "status": "A",
        "authorized_official_last_name": "MASON",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "JOHNSON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "256-345-3996",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Montelissa Residential",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joseph Michael Molisani, DDS
• Michael Dennis Monaghan, CRNA
• Jason Mario Monge, DMD
• Chloe Taylor Monin, RBT
• Armando Monroy, MD
• Brittney Moody
• Danielle Marie Moon, CRNP
• Joseph Moon, PHARMD
• Emily Dawn Moore, CRNP
• Harley Nicole Moore

• Exclusive Provider Organization in Decatur, AL
• Providers in Decatur, AL by specialty
• Exclusive Provider Organization in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.