Organization
SOUTH HAVEN HEALTH AND REHABILITATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP CODY LONG (CFO)
(205) 391-3600
Entity
Organization
Contact information
Practice address
3141 OLD COLUMBIANA RD, HOOVER, AL 35226-3703
(205) 822-1580
Mailing address
3141 OLD COLUMBIANA RD, HOOVER, AL 35226-3703
(205) 822-1580
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012650
BCBS ID
AL
05
—
4753210S
—
AL
Enumeration date
05/27/2006
Last updated
10/28/2020
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