Organization
GRAND BAY CONVALESCENT HOME INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIMMIE L HALL (ASSISTANT ADMINISTRATOR)
(251) 865-6443
Entity
Organization
Contact information
Practice address
13750 HIGHWAY 90 WEST, GRAND BAY, AL 36541
(251) 865-6443
(251) 865-3610
Mailing address
PO BOX 328, GRAND BAY, AL 36541-0328
(251) 865-6443
(251) 865-3610
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
10610
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4752110S
—
AL
Enumeration date
08/18/2005
Last updated
08/22/2020
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