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Ball HealthCare-Dallas, L.L.C.

Details

Name: Ball HealthCare-Dallas, L.L.C.
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 11 Dec 1998 (26 years ago)
Entity Number: 000-662-273
Register Number: 000662273
County: Mobile
Place of Formation: Mobile County
Principal Address: MOBILE, AL
Registered Office Street Address: ONE SOUTHERN WAYMOBILE, AL 36619
Registered Office Street Address ZIP Code: 36619

Activities OWN A NURSING HOME/ASSISTED LIVING FACILITY

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1932112430 2006-08-14 2016-03-31 1 SOUTHERN WAY, MOBILE, AL, 366191210, US 2911 EARL GOODWIN PKWY, SELMA, AL, 367032825, US

Contacts

Phone +1 251-433-9801
Fax 2514339807
Phone +1 334-875-1868
Fax 3348756650

Authorized person

Name MRS. ARMELIA K OLIVER
Role ADMINISTRATOR
Phone 3348751868

Taxonomy

Taxonomy Code 314000000X - Skilled Nursing Facility
License Number 12522
State AL
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number 4757760S
State AL

Member

Name Role
BALL FAMILY LIMITED PARTNERSHIP LLLP Member

Agent

Name Role Address
BALL, CLARENCE M JR Agent ONE SOUTHERN WAYMOBILE, AL 36619

Date of last update: 15 Aug 2024

Sources: Alabama Secretary of State