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Organization

DIVERSICARE LEASING LP

Active
Other names
Lynwood Nursing Home
Organization subpart
No

Provider details

NPI number
Authorized official
MATTHEW J. WEISHAAR (CHIEF FINANCIAL OFFICER AND SECRETA)
(615) 550-9459
Entity
Organization

Contact information

Practice address
700 HUTCHINS AVE, GADSDEN, AL 35901-1876
(256) 543-7101
(256) 543-2367
Mailing address
700 HUTCHINS AVE, GADSDEN, AL 35901-1876
(256) 543-7101
(256) 543-2367

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
N2806
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
47-56200S
AL
Enumeration date
10/06/2005
Last updated
01/20/2023
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