Healthcare Provider Details

I. General information

NPI: 1679367320
Provider Name (Legal Business Name): RECREANTUR HOME HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2025
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 SOUTHBRIDGE PKWY STE 650
BIRMINGHAM AL
35209-1317
US

IV. Provider business mailing address

PO BOX 2551
BIRMINGHAM AL
35202-2551
US

V. Phone/Fax

Practice location:
  • Phone: 205-922-6862
  • Fax:
Mailing address:
  • Phone: 205-563-1941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MR. FREDERICK C. CROCHEN
Title or Position: DIRECTOR
Credential:
Phone: 205-563-1941