Provider Demographics
NPI:1235678152
Name:AZALEA PARK HEALTH & REHAB INC
Entity Type:Organization
Organization Name:AZALEA PARK HEALTH & REHAB INC
Other - Org Name:AZALEA PARK HEALTH & REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-546-5980
Mailing Address - Street 1:100 PERRY HILL RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36109-3630
Mailing Address - Country:US
Mailing Address - Phone:334-273-9002
Mailing Address - Fax:334-273-9878
Practice Address - Street 1:3312 WOODLEY RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-3155
Practice Address - Country:US
Practice Address - Phone:334-288-2780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-13
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility