Organization
LAFAYETTE EXTENDED CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. YVONNE BUTLER (ADMINISTRATOR)
(334) 864-8854
Entity
Organization
Contact information
Practice address
805 HOSPITAL ST, LAFAYETTE, AL 36862-2817
(334) 864-8854
(334) 864-8851
Mailing address
PO BOX 152, LAFAYETTE, AL 36862-0152
(334) 864-8854
(334) 864-8851
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
12494
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4755600S
—
AL
Enumeration date
06/13/2006
Last updated
08/22/2020
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