| 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) (Companies founded in January 2000) |
| Entity Number: | 000-668-054 |
| Register Number: | 000668054 |
| Historical Names: |
Crossville Health and Rehabilitation, L.L.C
|
| ZIP code: | 35203 (Companies in Jefferson, 35203) |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 420 NORTH TWENTIETH ST STE 3100BIRMINGHAM, AL 35203 |
Activities
OPERATE/OWN/MANAGE/ETC SINGLE SKILLED CARE NURSING FACILITY
| 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 | |||||||||||||||||||
|
|||||||||||||||||||||||
| 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 |
| Name | Role | Address |
|---|---|---|
| CHRISTIAN, EDWARD R | Agent | 420 20TH ST N STE 3400BIRMINGHAM, AL 35203 |
| Name | Role |
|---|---|
| NORTHPORT HOLDING LLC | Member |
| 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
