Healthcare Provider Details

I. General information

NPI: 1023383924
Provider Name (Legal Business Name): RESPITE CARE FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2012
Last Update Date: 03/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 WATER ST SUITE 311
MONTGOMERY AL
36104-2501
US

IV. Provider business mailing address

300 WATER ST SUITE 311
MONTGOMERY AL
36104-2501
US

V. Phone/Fax

Practice location:
  • Phone: 334-262-3002
  • Fax: 334-262-3036
Mailing address:
  • Phone: 334-262-3002
  • Fax: 334-262-3036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateAL

VIII. Authorized Official

Name: MRS. MARCELLA BROWN
Title or Position: CONSULTANT
Credential: CRNP
Phone: 334-262-3002