Provider Demographics
NPI:1194352120
Name:MONTESSORI MENTAL HEALTH LLC
Entity type:Organization
Organization Name:MONTESSORI MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KADMIEL
Authorized Official - Middle Name:CALEB
Authorized Official - Last Name:SAINTANGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-226-3878
Mailing Address - Street 1:4607 LAKEVIEW DR NW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35810-2249
Mailing Address - Country:US
Mailing Address - Phone:256-226-3878
Mailing Address - Fax:
Practice Address - Street 1:209 GLEN MEADOW LN
Practice Address - Street 2:
Practice Address - City:HARVEST
Practice Address - State:AL
Practice Address - Zip Code:35749-8995
Practice Address - Country:US
Practice Address - Phone:256-226-3878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-27
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities