Provider Demographics
NPI:1669558086
Name:ST. CLAIR HEALTH & REHAB, INC.
Entity type:Organization
Organization Name:ST. CLAIR HEALTH & REHAB, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:GANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-640-5212
Mailing Address - Street 1:7300 HIGHWAY 78E
Mailing Address - Street 2:
Mailing Address - City:PELL CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35128
Mailing Address - Country:US
Mailing Address - Phone:205-640-5212
Mailing Address - Fax:205-640-7782
Practice Address - Street 1:7300 HWY 78E
Practice Address - Street 2:
Practice Address - City:PELL CITY
Practice Address - State:AL
Practice Address - Zip Code:35128
Practice Address - Country:US
Practice Address - Phone:205-640-5212
Practice Address - Fax:205-640-7782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12673314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL4757650SMedicaid
AL4757650SMedicaid
AL015400Medicare Oscar/Certification