Organization
CIVIC CENTER 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
1201 22ND ST N, BIRMINGHAM, AL 35234-2726
(205) 251-5271
Mailing address
1201 22ND ST N, BIRMINGHAM, AL 35234-2726
(205) 251-5271
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
013203
BCBS ID
AL
05
—
4757590S
—
AL
Enumeration date
05/26/2006
Last updated
09/11/2020
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