Name: | Crowne Health Care of Montgomery, LLC |
Jurisdiction: | Alabama |
Legal type: | Domestic Limited Liability Company |
Status: | Exists |
Date of registration: | 12 Sep 2003 (21 years ago) |
Entity Number: | 000-693-092 |
Register Number: | 000693092 |
County: | Monroe |
Place of Formation: | Montgomery County |
Principal Address: | MONTGOMERY, AL |
Registered Office Street Address: | 501 WHETSTONE STREETMONROEVILLE, AL 36460 |
Registered Office Street Address ZIP Code: | 36460 |
Activities
OPERATE SKILLED CARE NURSING FACILITIES
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1679532238 | 2006-03-22 | 2024-03-06 | 501 WHETSTONE ST, MONROEVILLE, AL, 364602615, US | 1837 UPPER WETUMPKA RD, MONTGOMERY, AL, 361071333, US | |||||||||||||||||||||||||||||
|
Phone | +1 251-743-3609 |
Fax | 2515755618 |
Phone | +1 334-264-8416 |
Fax | 3342641169 |
Authorized person
Name | NOEL DUNNAM |
Role | CFO |
Phone | 2517437137 |
Taxonomy
Taxonomy Code | 313M00000X - Nursing Facility/Intermediate Care Facility |
License Number | 12648 |
State | AL |
Is Primary | Yes |
Other Provider Identifiers
Issuer | MEDICAID |
Number | 4757830S |
State | AL |
Name | Role |
---|---|
DUNNAM, NOEL N | Agent |
Name | Role |
---|---|
CROWNE MANAGEMENT CORPORATION | Member |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State