| Name: | Grand Bay Convalescent Home, Incorporated |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 04 Jun 1985 (39 years ago) (Companies founded in June 1985) |
| Entity Number: | 000-104-319 |
| Register Number: | 000104319 |
| ZIP code: | 36541 (Companies in Mobile, 36541) |
| County: | Mobile |
| Place of Formation: | Mobile County |
| Principal Address: | GRAND BAY, AL |
| Registered Office Street Address: | 13750 HWY 90 WGRAND BAY, AL 36541 |
| Authorized Capital: | $1,000 |
Activities
NURSING HOMES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1386636033 | 2005-08-18 | 2020-08-22 | PO BOX 328, GRAND BAY, AL, 365410328, US | 13750 HIGHWAY 90 WEST, GRAND BAY, AL, 36541, US | |||||||||||||||||||||||||
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| Phone | +1 251-865-6443 |
| Fax | 2518653610 |
Authorized person
| Name | JIMMIE L HALL |
| Role | ASSISTANT ADMINISTRATOR |
| Phone | 2518656443 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | 10610 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 4752110S |
| State | AL |
| Name | Role |
|---|---|
| HART, MARLENE | Agent |
| Name | Role |
|---|---|
| HART, MCCONNELL L | Incorporator |
| HART, GERALD B | Incorporator |
Date of last update: 31 Jul 2024
Sources: Alabama Secretary of State
