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Organization

DIVERSICARE OF LANETT, LLC

Active
Parent organization
DIVERSICARE LEASING COMPANY III, LLC
Other names
Diversicare of Lanett
Organization subpart
Yes

Provider details

NPI number
Legal business name
DIVERSICARE LEASING COMPANY III, LLC
Authorized official
MATTHEW J WEISHAAR (CHIEF FINANCIAL OFFICER)
(615) 550-9459
Entity
Organization

Contact information

Practice address
702 S 13TH ST, LANETT, AL 36863-2834
(334) 644-1111
(615) 620-7875
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
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
198991
AL
Enumeration date
08/18/2016
Last updated
04/07/2023
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