| Name: | Ashland Place Health and Rehabilitation, L.L.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 29 Mar 2013 (12 years ago) (Companies founded in March 2013) |
| Entity Number: | 000-073-707 |
| Register Number: | 000073707 |
| Historical Names: |
Azalea Gardens Health and Rehabilitation, L.L.C.
|
| ZIP code: | 35403 (Companies in Tuscaloosa, 35403) |
| County: | Tuscaloosa |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 420 NORTH 20TH STREET SUITE 3400BIRMINGHAM, AL 35403 |
Activities
OPERATE SKILLED CARE NURSING FACILITY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1770921199 | 2013-06-07 | 2020-10-28 | 148 TUSCALOOSA ST, MOBILE, AL, 366073408, US | 148 TUSCALOOSA ST, MOBILE, AL, 366073408, US | |||||||||||||||||||||
|
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| Phone | +1 251-471-5431 |
| Fax | 2514760563 |
Authorized person
| Name | PHILLIP CODY LONG |
| Role | VICE PRESIDENT |
| Phone | 2053913600 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 153786 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| CHRISTIAN, EDWARD R | Agent | 420 20TH ST N STE 3400BIRMINGHAM, AL 35203 |
| Name | Role | Address |
|---|---|---|
| SPRAGUE, ROBERT | Organizer | 931 FAIRFAX PARKTUSCALOOSA, AL 35406 |
| HELMS, ANITA | Organizer | 931 FAIRFAX PARKTUSCALOOSA, AL 35406 |
| STEPHENSON, JACK P JR | Organizer | 420 N 20TH STREET STE 3400BIRMINGHAM, AL 35203 |
| CRANE, CONNIE | Organizer | 931 FAIRFAX PARKTUSCALOOSA, AL 35406 |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2013-04-26 | Name Change | Azalea Gardens Health and Rehabilitation, L.L.C. | Ashland Place Health and Rehabilitation, L.L.C. |
Date of last update: 31 Jul 2024
Sources: Alabama Secretary of State
