Organization
BLUE RIDGE HEALTHCARE WILLOW TRACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADMINISTRATOR ADMINISTRATOR (ADMINISTRATOR)
(205) 459-5506
Entity
Organization
Contact information
Practice address
1406 E PUSHMATAHA ST, BUTLER, AL 36904-2728
(205) 459-5506
Mailing address
1406 E PUSHMATAHA ST, BUTLER, AL 36904-2728
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
10/12/2017
Last updated
03/25/2019
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