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General NPI Number Information
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NPI Number | 1982883658
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Entity Type | Organization
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Legal Business Name | HANDICAPPED ENVIROMENTAL LIVING PROGRAM, INC.
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Dates
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Enumeration Date | 10/30/2007
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Last Update Date | 10/30/2007
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Provider Practice Location Address
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Address Line | 2820 MILTON RD
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City | MONTGOMERY
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State | AL
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Zip | 36110-1312
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Country | US
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Telephone | 334-269-5762
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Fax | 334-269-5709
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Provider Business Mailing Address
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Address Line | 2820 MILTON RD
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City | MONTGOMERY
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State | AL
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Zip | 36110-1312
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Country | US
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Telephone | 334-269-5762
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Fax | 334-269-5709
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Authorized Official
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Title or Position | BOOKKEEPER
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Name | MS. PAMELA T. KNOX
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Credential |
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Telephone | 334-230-1945
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 251S00000X
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License Number State | AL
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