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General NPI Number Information
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NPI Number | 1346683042
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Entity Type | Individual
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Provider Name | MAURICE MONYA WESS
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Gender | Male
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Dates
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Enumeration Date | 04/11/2013
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Last Update Date | 09/17/2013
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Provider Practice Location Address
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Address Line | 1 PERIMETER PARK S SUITE 100 N
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City | BIRMINGHAM
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State | AL
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Zip | 35243-2327
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Country | US
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Telephone | 205-234-5843
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Fax |
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Provider Business Mailing Address
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Address Line | 3220 SHADOW SPRINGS PL
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City | SAN JOSE
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State | CA
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Zip | 95121-1768
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Country | US
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Telephone | 601-310-8492
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | MONYA8492
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | AL
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