Organization
MADISON MANOR NURSING HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NOEL DUNNAM (CFO)
(251) 743-7137
Entity
Organization
Contact information
Practice address
3891 SULLIVAN STREET, MADISON, AL 35758
(256) 772-9243
(256) 772-9233
Mailing address
501 WHETSTONE STREET, MONROEVILLE, AL 36460
(251) 743-3609
(251) 575-5618
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
12609
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4757500S
—
AL
Enumeration date
03/22/2006
Last updated
03/06/2024
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