Provider Demographics
NPI:1558318196
Name:FLORALA HEALTH AND REHABILITATION, LLC
Entity Type:Organization
Organization Name:FLORALA HEALTH AND REHABILITATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:CODY
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-391-3600
Mailing Address - Street 1:23621 GOLDENROD AVE
Mailing Address - Street 2:
Mailing Address - City:FLORALA
Mailing Address - State:AL
Mailing Address - Zip Code:36442-3652
Mailing Address - Country:US
Mailing Address - Phone:334-858-8585
Mailing Address - Fax:
Practice Address - Street 1:23621 GOLDENROD AVE
Practice Address - Street 2:
Practice Address - City:FLORALA
Practice Address - State:AL
Practice Address - Zip Code:36442-3652
Practice Address - Country:US
Practice Address - Phone:334-858-8585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL012415OtherBCBS ID
AL4758140SMedicaid
AL012415OtherBCBS ID