Provider Demographics
NPI:1013115674
Name:SYLACAUGA HEALTH AND REHAB SERVICES, LLC
Entity Type:Organization
Organization Name:SYLACAUGA HEALTH AND REHAB SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR REGULATORY AFFAIRS
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:E
Authorized Official - Last Name:ESTEP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-783-8472
Mailing Address - Street 1:600 CORPORATE PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-2934
Mailing Address - Country:US
Mailing Address - Phone:205-783-8440
Mailing Address - Fax:205-783-8441
Practice Address - Street 1:1007 W FORT WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:SYLACAUGA
Practice Address - State:AL
Practice Address - Zip Code:35150-2301
Practice Address - Country:US
Practice Address - Phone:256-245-7402
Practice Address - Fax:256-207-3001
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NOLAND HEALTH SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-05
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALN6101314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL47-5317Medicaid
AL47-5317Medicaid
AL01-5160Medicare ID - Type Unspecified