Healthcare Provider Details

I. General information

NPI: 1417856808
Provider Name (Legal Business Name): CAMELLIA SPRINGS HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2026
Last Update Date: 11/03/2026
Certification Date: 11/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6532 WALNUT GROVE RD
ALTOONA AL
35952-8405
US

IV. Provider business mailing address

6532 WALNUT GROVE RD
ALTOONA AL
35952-8405
US

V. Phone/Fax

Practice location:
  • Phone: 205-589-6394
  • Fax: 205-589-2112
Mailing address:
  • Phone: 205-589-6394
  • Fax: 205-589-2112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: SOON BURNAM
Title or Position: SECRETARY
Credential:
Phone: 949-540-1249