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Crowne Health Care of Eufaula, LLC

Details

Name: Crowne Health Care of Eufaula, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 17 Sep 2003 (21 years ago) (Companies founded in September 2003)
Entity Number: 000-693-207
Register Number: 000693207
ZIP code: 36460 (Companies in Monroe, 36460)
County: Monroe
Place of Formation: Barbour County
Principal Address: EUFAULA, AL
Registered Office Street Address: 501 WHETSTONE STREETMONROEVILLE, AL 36460

Activities OPERATE SKILLED NURSING CARE FACILITIES

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1043279532 2006-03-22 2024-03-06 501 WHETSTONE ST, MONROEVILLE, AL, 364602615, US 430 RIVERS AVE, EUFAULA, AL, 360271820, US

Contacts

Phone +1 251-743-3609
Fax 2515755618
Phone +1 334-687-6627
Fax 3346877538

Authorized person

Name NOEL DUNNAM
Role CFO
Phone 2517437137

Taxonomy

Taxonomy Code 313M00000X - Nursing Facility/Intermediate Care Facility
License Number 12480
State AL
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number 4757440S
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