Healthcare Provider Details

I. General information

NPI: 1689099095
Provider Name (Legal Business Name): CAMELLIA HOME HEALTH OF ALABAMA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2014
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9668 MADISON BLVD STE 335
MADISON AL
35758-9147
US

IV. Provider business mailing address

6688 N CENTRAL EXPY STE 1300
DALLAS TX
75206-3950
US

V. Phone/Fax

Practice location:
  • Phone: 256-203-8508
  • Fax: 256-288-0822
Mailing address:
  • Phone: 214-239-6500
  • Fax: 214-239-6581

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number19141
License Number StateAL

VIII. Authorized Official

Name: LISA M ARBUCKLE
Title or Position: DIRECTOR, LICENSING & ENROLLMENT
Credential:
Phone: 214-239-6500