Organization
TALLASSEE HEALTH AND REHABILITATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP CODY LONG (CFO)
(205) 391-3600
Entity
Organization
Contact information
Practice address
2639 GILMER AVE, TALLASSEE, AL 36078-7231
(334) 283-3975
Mailing address
2639 GILMER AVE, P. O. BOX 780277, TALLASSEE, AL 36078-7231
(334) 283-3975
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014229
BCBS ID
AL
05
—
4753620S
—
AL
Enumeration date
05/27/2006
Last updated
10/12/2020
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