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Organization

AL CITRONELLE LLC

Active
Parent organization
GULF COAST FACILITIES LLC
Other names
Citronelle Health and Rehabilitation Center
Organization subpart
Yes

Provider details

NPI number
Legal business name
GULF COAST FACILITIES LLC
Authorized official
JAMES RICHARDSON (PRESIDENT)
(850) 430-0000
Entity
Organization

Contact information

Practice address
19225 N 4TH ST, CITRONELLE, AL 36522-2051
(334) 866-5509
Mailing address
40 PALAFOX PL, STE 400, PENSACOLA, FL 32502-5699
(850) 430-0000

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
475441
AL
Enumeration date
06/16/2008
Last updated
10/05/2015
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