| Name: | Arbor Lake Health & Rehab, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 23 Sep 2022 (2 years ago) |
| Entity Number: | 001-041-437 |
| Register Number: | 001041437 |
| County: | Lee |
| Place of Formation: | Alabama |
| Registered Office Street Address: | 495 Lee Road 14Auburn, AL 36830 |
| Registered Office Street Address ZIP Code: | 36830 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1194449843 | 2022-09-27 | 2022-09-27 | 1365 GATEWOOD DR, AUBURN, AL, 368302834, US | 1365 GATEWOOD DR, AUBURN, AL, 368302834, US | |||||||||||||||||||||
|
|||||||||||||||||||||||||
| Phone | +1 334-826-7200 |
| Fax | 3348217239 |
Authorized person
| Name | MATTHEW LEWIS |
| Role | ADMINISTRATOR/OWNER |
| Phone | 3348267200 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 4758150S |
| State | AL |
| Name | Role |
|---|---|
| OB MANAGEMENT, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| Traylor, Jonathan M | Organizer | 495 Lee Road 14Auburn, AL 36830 |
Date of last update: 17 Aug 2024
Sources: Alabama Secretary of State
