| Name: | DAC OF MARION, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Limited Liability Company |
| Status: | Exists |
| Date of registration: | 27 Jan 2022 (3 years ago) |
| Entity Number: | 001-002-920 |
| Register Number: | 001002920 |
| County: | Montgomery |
| Place of Formation: | Delaware |
| Principal Address: | 1621 Galleria BoulevardBrentwood, TN 37027-2926 |
| Registered Office Street Address: | 641 South Lawrence StreetMontgomery, AL 36104 |
| Registered Office Street Address ZIP Code: | 36104 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1669115309 | 2022-04-20 | 2023-04-07 | 1621 GALLERIA BLVD, BRENTWOOD, TN, 370272926, US | 505 E LAFAYETTE ST, MARION, AL, 367562323, US | |||||||||||||||||||||||||||||
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| Phone | +1 615-550-9453 |
| Fax | 6159156935 |
| Phone | +1 334-683-9696 |
Authorized person
| Name | MATTHEW J. WEISHAAR |
| Role | CHIEF FINANCIAL OFFICER |
| Phone | 6155509459 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE - PTAN |
| Number | 01-5158 |
| State | AL |
| Issuer | MEDICAID |
| Number | 294722 |
| State | AL |
| Name | Role |
|---|---|
| Corporation Service Company, Inc. | Agent |
Date of last update: 17 Aug 2024
Sources: Alabama Secretary of State
