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
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