Organization
DIVERSICARE HARTFORD, LLC
Active
Parent organization
DIVERSICARE HEALTHCARE SERVICES LLC
Other names
Hartford Health Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
DIVERSICARE HEALTHCARE SERVICES LLC
Authorized official
MATTHEW J WEISHAAR (CHIEF FINANCIAL OFFICER)
(615) 550-9459
Entity
Organization
Contact information
Practice address
217 TORO RD, HARTFORD, AL 36344-1459
(334) 588-3842
(334) 588-3052
Mailing address
1621 GALLERIA BLVD, BRENTWOOD, TN 37027-2926
(615) 550-9453
(615) 915-6935
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
N3102
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47-57910S
—
AL
Enumeration date
10/05/2005
Last updated
04/07/2023
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