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Florence Nursing and Rehabilitation Center, LLC

Details

Name: Florence Nursing and Rehabilitation Center, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 07 May 2003 (22 years ago) (Companies founded in May 2003)
Entity Number: 000-689-936
Register Number: 000689936
ZIP code: 36104 (Companies in Montgomery, 36104)
County: Montgomery
Place of Formation: Montgomery County
Principal Address: MONTGOMERY, AL
Registered Office Mailing Address: 444 S PERRY STMONTGOMERY, AL 36104-0347
Registered Office Street Address: 444 S PERRY STMONTGOMERY, AL 36104

Activities OPERATE/MANAGE HEALTH CARE FACILITIES/SKILLED NURSING SERVICES

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1972676104 2006-11-16 2023-12-08 PO BOX 428, ORCHARD PARK, NY, 141270428, US 2107 CLOYD BLVD, FLORENCE, AL, 356301503, US

Contacts

Phone +1 716-662-4955
Fax 7166679230
Phone +1 256-766-5771
Fax 2567668135

Authorized person

Name MR. NORBERT A BENNETT
Role CO-CHIEF EXECUTIVE OFFICER
Phone 7166624955

Taxonomy

Taxonomy Code 314000000X - Skilled Nursing Facility
License Number 12593
State AL
Is Primary Yes

Other Provider Identifiers

Issuer BC BS OF ALABAMA
Number 00387
State AL
Issuer MEDICARE COMPLETE
Number 71-00015
State AL
Issuer MEDICAID
Number 4757540S
State AL

Member

Name Role
LKC LLC Member
D & N LLC Member
DTD HC LLC Member

Agent

Name Role Address
GILL, RICHARD H Agent 444 SOUTH PERRY STREETMONTGOMERY, AL 36101

Date of last update: 15 Aug 2024

Sources: Alabama Secretary of State