| Name: | Park Manor Health and Rehabilitation, L.L.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 08 Nov 2002 (22 years ago) |
| Entity Number: | 000-686-004 |
| Register Number: | 000686004 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Principal Address: | BIRMINGHAM, AL |
| Registered Office Street Address: | 420 N 20TH ST STE 3100BIRMINGHAM, AL 35203 |
| Registered Office Street Address ZIP Code: | 35203 |
Activities
OPERATE SKILLED CARE NURSING FACILITIES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1407803109 | 2006-05-28 | 2020-10-01 | 2201 MCFARLAND BLVD, NORTHPORT, AL, 354762943, US | 2201 MCFARLAND BLVD, NORTHPORT, AL, 354762943, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 205-339-5300 |
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 | 010689 |
| State | AL |
| Issuer | MEDICAID |
| Number | 4757090S |
| State | AL |
| Name | Role |
|---|---|
| NHS OPERATIONS LLC | Member |
| Name | Role | Address |
|---|---|---|
| CHRISTIAN, EDWARD R | Agent | 420 20TH ST N STE 3400BIRMINGHAM, AL 35203 |
| Contract Type | Award or IDV Flag | PIID | Start Date | Current End Date | Potential End Date | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DELIVERY ORDER | AWARD | VA24712J5065 | 2012-09-28 | 2013-07-31 | 2013-07-31 | |||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||
| Obligated Amount | 40376.18 |
| Current Award Amount | 40376.18 |
| Potential Award Amount | 40376.18 |
Description
| Title | NURSING HOME IGF::OT::IGF |
| NAICS Code | 623110: NURSING CARE FACILITIES |
| Product and Service Codes | Q402: MEDICAL- NURSING HOME CARE CONTRACTS |
Recipient Details
| Recipient | PARK MANOR HEALTH & REHABILITATION L L C |
| UEI | FRC5J6N5HK95 |
| Recipient Address | UNITED STATES, 2201 MCFARLAND BLVD, NORTHPORT, TUSCALOOSA, ALABAMA, 354762943 |
| Unique Award Key | CONT_AWD_VA679C21067_3600_VA247BO0052_3600 |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Award Amounts
| Obligated Amount | 125749.91 |
| Current Award Amount | 125749.91 |
| Potential Award Amount | 125749.91 |
Description
| Title | NURSING HOME |
| NAICS Code | 623110: NURSING CARE FACILITIES |
| Product and Service Codes | Q402: MEDICAL- NURSING HOME CARE CONTRACTS |
Recipient Details
| Recipient | PARK MANOR HEALTH & REHABILITATION L L C |
| UEI | FRC5J6N5HK95 |
| Recipient Address | UNITED STATES, 2201 MCFARLAND BLVD, NORTHPORT, TUSCALOOSA, ALABAMA, 354762943 |
| Unique Award Key | CONT_AWD_VA679C005291_3600_VA247BO0052_3600 |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Award Amounts
| Obligated Amount | 57788.23 |
| Current Award Amount | 57788.23 |
| Potential Award Amount | 57788.23 |
Description
| Title | NURSING HOME SERVICES |
| NAICS Code | 623110: NURSING CARE FACILITIES |
| Product and Service Codes | Q402: NURSING HOME CARE CONTRACTS |
Recipient Details
| Recipient | PARK MANOR HEALTH & REHABILITATION L L C |
| UEI | FRC5J6N5HK95 |
| Recipient Address | UNITED STATES, 2201 MCFARLAND BLVD, NORTHPORT, TUSCALOOSA, ALABAMA, 354762943 |
| Unique Award Key | CONT_IDV_VA247BO0052_3600 |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Description
| Title | NURSING HOME |
| NAICS Code | 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES) |
| Product and Service Codes | Q402: NURSING HOME CARE CONTRACTS |
Recipient Details
| Recipient | PARK MANOR HEALTH & REHABILITATION L L C |
| UEI | FRC5J6N5HK95 |
| Legacy DUNS | 144573859 |
| Recipient Address | UNITED STATES, 2201 MCFARLAND BLVD, NORTHPORT, 354762943 |
| Unique Award Key | CONT_AWD_VA679C00521_3600_VA247BO0052_3600 |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Award Amounts
| Obligated Amount | 27820.10 |
| Current Award Amount | 27820.10 |
| Potential Award Amount | 27820.10 |
Description
| Title | NURSING HOME SERVICES |
| NAICS Code | 623110: NURSING CARE FACILITIES |
| Product and Service Codes | Q402: NURSING HOME CARE CONTRACTS |
Recipient Details
| Recipient | PARK MANOR HEALTH & REHABILITATION L L C |
| UEI | FRC5J6N5HK95 |
| Recipient Address | UNITED STATES, 2201 MCFARLAND BLVD, NORTHPORT, TUSCALOOSA, ALABAMA, 354762943 |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
