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Organization

DIVERSICARE OF HUEYTOWN, LLC

Active
Parent organization
DIVERSICARE HEALTHCARE SERVICES LLC
Other names
Baron House of Hueytown
Organization subpart
Yes

Provider details

NPI number
Legal business name
DIVERSICARE HEALTHCARE SERVICES LLC
Authorized official
MATTHEW J. WEISHAAR (CHIEF FINANCIAL OFFICER & SECRETARY)
(615) 771-7575
Entity
Organization

Contact information

Practice address
190 BROOKLANE DR, HUEYTOWN, AL 35023-2368
(205) 491-2905
(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
199000
AL
Enumeration date
08/18/2016
Last updated
04/07/2023
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