Organization
DHS OF BLOUNT COUNTY, LLC
Active
Other names
TLC NURSING CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAREN SUE JOHNSON (ADMINISTRATOR)
(205) 625-3520
Entity
Organization
Contact information
Practice address
212 ELLEN ST, ONEONTA, AL 35121-2720
(205) 625-3520
(205) 625-3680
Mailing address
212 ELLEN ST, P.O. BOX 698, ONEONTA, AL 35121-2720
(205) 625-3520
(205) 625-3680
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
10468
AL
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011251
BLUE CROSS BLUE SHIELD
AL
05
—
4757940S
—
AL
01
—
51521486
BLUE CROSS BLUE SHIELD
AL
Enumeration date
08/17/2005
Last updated
07/21/2022
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