Provider Demographics
NPI:1629065289
Name:PREFERRED HEALTH HOLDINGS LLC
Entity Type:Organization
Organization Name:PREFERRED HEALTH HOLDINGS LLC
Other - Org Name:MARSHALL MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:SOUTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-582-6561
Mailing Address - Street 1:3120 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:GUNTERSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35976-2912
Mailing Address - Country:US
Mailing Address - Phone:256-582-6561
Mailing Address - Fax:
Practice Address - Street 1:3120 NORTH ST
Practice Address - Street 2:
Practice Address - City:GUNTERSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35976-2962
Practice Address - Country:US
Practice Address - Phone:256-582-6561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PREFERRED HEALTH HOLDINGS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-09-29
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10607314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL4757250SMedicaid
AL4757250SMedicaid