| Name: | Wheat Nursing Home, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Dissolved |
| Date of registration: | 15 Jun 1974 (50 years ago) (Companies founded in June 1974) |
| Date of dissolution: | 25 Aug 2017 |
| Entity Number: | 000-034-577 |
| Register Number: | 000034577 |
| Place of Formation: | Pickens County |
| Principal Address: | ALICEVILLE, AL |
| Authorized Capital: | $1,000 |
| Paid Share Capital: | $1,000 |
Activities
OPERATE NURSING HOME
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043217375 | 2005-07-01 | 2008-04-30 | 703 17TH ST NW, ALICEVILLE, AL, 354421426, US | 703 17TH ST NW, ALICEVILLE, AL, 354421426, US | |||||||||||||||||||||||||
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| Phone | +1 205-373-6307 |
| Fax | 2053732737 |
Authorized person
| Name | MR. MARK EVAN WHEAT |
| Role | ADMINISTRATOR/OWNER |
| Phone | 2053736307 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | 4754610S |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 4754610S |
| State | AL |
| Name | Role |
|---|---|
| WHEAT, HARRY H | Incorporator |
| WHEAT, CLEM MARTIN | Incorporator |
| WHEAT, HARRY H III | Incorporator |
| WHEAT, MARK EVAN | Incorporator |
| Contract Type | Award or IDV Flag | PIID | Start Date | Current End Date | Potential End Date | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DCA | AWARD | VA247P0517 | 2008-07-01 | 2009-06-30 | 2013-06-30 | |||||||||||||||||||||
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| Title | NURSING HOME |
| NAICS Code | 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES) |
| Product and Service Codes | Q402: NURSING HOME CARE CONTRACTS |
Recipient Details
| Recipient | WHEAT NURSING HOME, INC. |
| UEI | JBQBC1B72F56 |
| Legacy DUNS | 078958055 |
| Recipient Address | UNITED STATES, 703 17TH ST NW, ALICEVILLE, 354421426 |
Date of last update: 30 Jul 2024
Sources: Alabama Secretary of State
