Organization
TI-RESURRECTION LIFE CENTER, L.L.C.
Active
Other names
Charlton Place Rehabilitation & Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH TUTERA (MANAGER)
(866) 444-0900
Entity
Organization
Contact information
Practice address
65 CHARLTON PLACE, DEATSVILLE, AL 36022
(334) 263-0618
Mailing address
65 CHARLTON PLACE, DEATSVILLE, AL 36022
(334) 263-0618
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
D0108
AL
314000000X
Skilled Nursing Facility
Primary
N0101
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4752130S
MEDICAID
AL
Enumeration date
07/10/2007
Last updated
04/23/2021
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