MEDICARE: COTTAGES MONTGOMERY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1124611785
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COTTAGES MONTGOMERY, LLC

Provider Business Mailing Address
First Line	:	235 SYLVEST DR
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36117-2813
Country	:	US
Telephone Number	:	334-260-8373
Fax Number	:

Provider Business Practice Location Address
First Line	:	235 SYLVEST DR
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36117-2813
Country	:	US
Telephone Number	:	334-260-8373
Fax Number	:

Authorized Official
Title or Position	:	OPERATIONS MANAGER
Name	:	CHERYL WESTLAKE
Credential	:
Telephone Number	:	256-929-7536

Provider Enumeration Date	:	02/15/2021
Last Update Date	:	02/15/2021

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