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Crowne Health Care of Mobile, LLC

Details

Name: Crowne Health Care of Mobile, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 15 Sep 2003 (21 years ago)
Entity Number: 000-693-169
Register Number: 000693169
County: Monroe
Place of Formation: Mobile County
Principal Address: MOBILE, 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
1154380632 2006-03-22 2024-03-06 501 WHETSTONE ST, MONROEVILLE, AL, 364602615, US 954 NAVCO RD, MOBILE, AL, 366052413, US

Contacts

Phone +1 251-743-3609
Fax 2515755618
Phone +1 251-473-8684
Fax 2514716329

Authorized person

Name NOEL DUNNAM
Role CFO
Phone 2517437137

Taxonomy

Taxonomy Code 313M00000X - Nursing Facility/Intermediate Care Facility
License Number 12633
State AL
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number 4754460S
State AL

Member

Name Role
CROWNE MANAGEMENT CORPORATION Member

Agent

Name Role
DUNNAM, NOEL N Agent

Date of last update: 15 Aug 2024

Sources: Alabama Secretary of State