Organization
AL WILLOW TREE, LLC
Active
Parent organization
GULF COAST FACILITIES, LLC
Other names
Willow Trace 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
1406 E PUSHMATAHA ST, BUTLER, AL 36904-2728
(205) 459-5506
(205) 459-5503
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
Enumeration date
06/11/2008
Last updated
10/05/2015
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