Resurrection Life Center

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

RESURRECTION LIFE CENTER

Practice address

1240 County Road 39
Deatsville, AL 36022-2536

Phone

(334) 263-0618

Fax

(334) 230-2056

NPI assigned

Jun 21, 2005

Organization subpart

No

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

Authorized official

Name

Manuel Williams, REV. C.R.

Title

Chief Executive Officer

Phone

(334) 263-4221

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Resurrection Catholic Missions Of The South Doing business as

Tax ID family

Father Walter Memorial Child Care Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Father Walter Memorial Child Care Center

  • Pediatric Skilled Nursing Facility
  • Montgomery, AL
  • NPI 1336137488
  NPD tax ID

Locations

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1972509453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 COUNTY ROAD 39",
            "city": "DEATSVILLE",
            "state": "AL",
            "postal_code": "360222536",
            "telephone_number": "334-263-0618",
            "fax_number": "334-230-2056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 COUNTY ROAD 39",
            "city": "DEATSVILLE",
            "state": "AL",
            "postal_code": "360222536",
            "telephone_number": "334-263-0618",
            "fax_number": "334-230-2056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESURRECTION LIFE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-21",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "334-263-4221",
        "authorized_official_credential": "REV. C.R."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4752130S",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Resurrection Catholic Missions Of The South",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Angela C Mims, RN CDCES
• Montgomery Drug Company Inc
• Jacey P Morgan, M.S., CCC-SLP
• Kristie Ragland Ninesling, LICSW, PIP
• Melinda Mims Peevy, R.PH.
• Hunter James Scott
• Amy Elizabeth Self, RD
• Ashley Stone Sellers, PHARMD
• Soulcare Counseling and Consulting
• Speak Easy Teletherapy, LLC

• Skilled Nursing Facility in Deatsville, AL
• Providers in Deatsville, AL by specialty
• Skilled Nursing Facility in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.