Provider Demographics
NPI:1952960122
Name:MORRIS, LATONYA SHAVONNE (CEO)
Entity type:Individual
Prefix:
First Name:LATONYA
Middle Name:SHAVONNE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:CEO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 VILLA GLEN APARTMENTS
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35020-6757
Mailing Address - Country:US
Mailing Address - Phone:205-484-1301
Mailing Address - Fax:
Practice Address - Street 1:204 VILLA GLEN APARTMENTS
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35020-6757
Practice Address - Country:US
Practice Address - Phone:205-484-1301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health