Organization
LEGACY HEALTH AND REHABILITATION OF PLEASANT GROVE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP CODY LONG (VICE-PRESIDENT)
(205) 391-3600
Entity
Organization
Contact information
Practice address
30 7TH ST, PLEASANT GROVE, AL 35127-1962
(205) 744-8226
Mailing address
30 7TH ST, PLEASANT GROVE, AL 35127-1962
(205) 744-8226
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
N3748
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
013348
BLUE CROSS BLUE SHIELD
AL
05
—
4758210S
—
AL
Enumeration date
07/06/2007
Last updated
10/28/2020
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