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Englewood Health Care Center, LLC

Details

Name: Englewood Health Care Center, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 12 Sep 2003 (21 years ago)
Entity Number: 000-693-130
Register Number: 000693130
County: Monroe
Place of Formation: Monroe County
Principal Address: MONROEVILLE, AL
Registered Office Street Address: 501 WHETSTONE STREETMONROEVILLE, AL 36460
Registered Office Street Address ZIP Code: 36460

Activities OPERATE SKILLED CARE NURSING FACILITIES

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1164481826 2006-03-21 2024-03-06 501 WHETSTONE ST, MONROEVILLE, AL, 36460, US 2046 S ALABAMA AVE, MONROEVILLE, AL, 364603044, US

Contacts

Phone +1 251-743-3609
Fax 2517439763
Phone +1 251-575-3285

Authorized person

Name NOEL DUNNAM
Role CFO
Phone 2517437137

Taxonomy

Taxonomy Code 313M00000X - Nursing Facility/Intermediate Care Facility
License Number 12645
State AL
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number 4754190S
State AL

Agent

Name Role
DUNNAM, NOEL N Agent

Member

Name Role
CROWNE MANAGEMENT CORPORATION Member

Date of last update: 15 Aug 2024

Sources: Alabama Secretary of State