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Atmore Nursing Center, LLC

Details

Name: Atmore Nursing Center, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 16 Sep 2003 (21 years ago) (Companies founded in September 2003)
Entity Number: 000-693-203
Register Number: 000693203
ZIP code: 36460 (Companies in Monroe, 36460)
County: Monroe
Place of Formation: Escambia County
Principal Address: ATMORE, AL
Registered Office Street Address: 501 WHETSTONE STREETMONROEVILLE, AL 36460

Activities OPERATE SKILLED CARE NURSING FACILITIES

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1740249200 2006-03-22 2024-03-06 501 WHETSTONE ST, MONROEVILLE, AL, 364602615, US 715 E LAUREL ST, ATMORE, AL, 365023113, US

Contacts

Phone +1 251-743-3609
Fax 2515755618
Phone +1 251-368-9121
Fax 2513682542

Authorized person

Name NOEL DUNNAM
Role CFO
Phone 2517437137

Taxonomy

Taxonomy Code 313M00000X - Nursing Facility/Intermediate Care Facility
License Number 12531
State AL
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number 4757400S
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