Provider Demographics
NPI:1710983762
Name:USA HEALTHCARE WOODLAND HAUS LLC
Entity Type:Organization
Organization Name:USA HEALTHCARE WOODLAND HAUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAVEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-739-2988
Mailing Address - Street 1:1900 OLIVE ST SW
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-7202
Mailing Address - Country:US
Mailing Address - Phone:256-739-2988
Mailing Address - Fax:256-775-0078
Practice Address - Street 1:1900 OLIVE ST SW
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-7202
Practice Address - Country:US
Practice Address - Phone:256-739-2988
Practice Address - Fax:256-775-0078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10051310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility