Name: | Northway Health and Rehabilitation, L.L.C. |
Jurisdiction: | Alabama |
Legal type: | Domestic Limited Liability Company |
Status: | Exists |
Date of registration: | 07 Sep 2000 (24 years ago) |
Entity Number: | 000-671-708 |
Register Number: | 000671708 |
County: | Jefferson |
Place of Formation: | Jefferson County |
Principal Address: | BIRMINGHAM, AL |
Registered Office Street Address: | 420 NORTH TWENTIETH ST STE 3100BIRMINGHAM, AL 35203 |
Registered Office Street Address ZIP Code: | 35203 |
Activities
ACQUIRE/OPERATE/OWN SKILLED CARE NURSING FACILITIES
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1811943152 | 2006-05-26 | 2020-09-14 | 1424 25TH ST N, BIRMINGHAM, AL, 352342819, US | 1424 25TH ST N, BIRMINGHAM, AL, 352342819, US | |||||||||||||||||||||||||
|
Phone | +1 205-328-5870 |
Authorized person
Name | PHILLIP CODY LONG |
Role | CFO |
Phone | 2053913600 |
Taxonomy
Taxonomy Code | 314000000X - Skilled Nursing Facility |
Is Primary | Yes |
Other Provider Identifiers
Issuer | BCBS ID |
Number | 012651 |
State | AL |
Issuer | MEDICAID |
Number | 4757850S |
State | AL |
Name | Role | Address |
---|---|---|
CHRISTIAN, EDWARD R | Agent | 420 20TH ST N STE 3400BIRMINGHAM, AL 35203 |
Name | Role |
---|---|
ESTATES, J NORMAN | Member |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State