Organization
EXTENDICARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID DENNIS (CEO)
(334) 793-1177
Entity
Organization
Contact information
Practice address
950 S SAINT ANDREWS ST, DOTHAN, AL 36301-3684
(334) 793-1177
(334) 699-3948
Mailing address
PMB 391, 104 APPLE AVE SUITE 3, DOTHAN, AL 36303
(334) 793-1177
(334) 699-3948
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
N3501
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4757020S
—
AL
Enumeration date
07/30/2006
Last updated
02/29/2024
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