Provider Demographics
NPI:1619482643
Name:RELIANCE ASSOCIATES, LLC
Entity Type:Organization
Organization Name:RELIANCE ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BILLIE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-255-6206
Mailing Address - Street 1:565 STATE ST
Mailing Address - Street 2:
Mailing Address - City:SUMITON
Mailing Address - State:AL
Mailing Address - Zip Code:35148-4630
Mailing Address - Country:US
Mailing Address - Phone:205-255-6206
Mailing Address - Fax:205-255-7180
Practice Address - Street 1:565 STATE ST
Practice Address - Street 2:
Practice Address - City:SUMITON
Practice Address - State:AL
Practice Address - Zip Code:35148-4630
Practice Address - Country:US
Practice Address - Phone:205-255-6206
Practice Address - Fax:205-255-7180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-13
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty