Provider Demographics
NPI:1033215215
Name:CONTEMPORARY ASSISTED LIVING, INC.
Entity Type:Organization
Organization Name:CONTEMPORARY ASSISTED LIVING, INC.
Other - Org Name:GORDON OAKS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-666-0250
Mailing Address - Street 1:3151 KNOLLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36693-2753
Mailing Address - Country:US
Mailing Address - Phone:251-661-7600
Mailing Address - Fax:251-661-6789
Practice Address - Street 1:3151 KNOLLWOOD DR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36693-2753
Practice Address - Country:US
Practice Address - Phone:251-661-7600
Practice Address - Fax:251-661-6789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11527310400000X
AL12770311500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Not Answered311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)