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Crossville Health Realty, L.L.C

Details

Name: Crossville Health Realty, L.L.C
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 12 Jan 2000 (25 years ago)
Entity Number: 000-668-054
Register Number: 000668054
Historical Names: Crossville Health and Rehabilitation, L.L.C
County: Jefferson
Place of Formation: Jefferson County
Registered Office Street Address: 420 NORTH TWENTIETH ST STE 3100BIRMINGHAM, AL 35203
Registered Office Street Address ZIP Code: 35203

Activities OPERATE/OWN/MANAGE/ETC SINGLE SKILLED CARE NURSING FACILITY

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1982644951 2006-06-07 2020-08-22 8922 HIGHWAY 227 NORTH, CROSSVILLE, AL, 35962, US 8922 HIGHWAY 227 NORTH, CROSSVILLE, AL, 35962, US

Contacts

Phone +1 256-528-7844

Authorized person

Name CLAUDE E LEE
Role CFO
Phone 2053913600

Taxonomy

Taxonomy Code 314000000X - Skilled Nursing Facility
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number 4754400S
State AL

Agent

Name Role Address
CHRISTIAN, EDWARD R Agent 420 20TH ST N STE 3400BIRMINGHAM, AL 35203

Member

Name Role
NORTHPORT HOLDING LLC Member

Events

Event Date Event Type Old Value New Value
2006-12-15 Name Change Crossville Health and Rehabilitation, L.L.C Crossville Health Realty, L.L.C

Date of last update: 15 Aug 2024

Sources: Alabama Secretary of State