Provider Demographics
NPI:1912301383
Name:ARBOR WOODS HEALTH AND REHAB LLC
Entity Type:Organization
Organization Name:ARBOR WOODS HEALTH AND REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:TRAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-749-1471
Mailing Address - Street 1:PO BOX 400
Mailing Address - Street 2:
Mailing Address - City:REFORM
Mailing Address - State:AL
Mailing Address - Zip Code:35481-0400
Mailing Address - Country:US
Mailing Address - Phone:205-375-6379
Mailing Address - Fax:205-375-8283
Practice Address - Street 1:515 2ND AVE NW
Practice Address - Street 2:
Practice Address - City:REFORM
Practice Address - State:AL
Practice Address - Zip Code:35481-2331
Practice Address - Country:US
Practice Address - Phone:205-375-6379
Practice Address - Fax:205-375-8283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-14
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALN5401314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL015141OtherPTAN NUMBER
AL314000000XOtherTAXONOMY CODE