Provider Demographics
NPI:1780779439
Name:HATLEY HEALTH CARE, INC.
Entity type:Organization
Organization Name:HATLEY HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RICHIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-755-4960
Mailing Address - Street 1:300 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:CLANTON
Mailing Address - State:AL
Mailing Address - Zip Code:35045-2321
Mailing Address - Country:US
Mailing Address - Phone:205-755-4960
Mailing Address - Fax:205-755-2455
Practice Address - Street 1:300 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:CLANTON
Practice Address - State:AL
Practice Address - Zip Code:35045-2321
Practice Address - Country:US
Practice Address - Phone:205-755-4960
Practice Address - Fax:205-755-2455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12497314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL010523OtherBLUE CROSS PROVIDER NO
AL4757430SMedicaid
AL015023Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
AL4757430SMedicaid