Healthcare Provider Details
I. General information
NPI: 1518956424
Provider Name (Legal Business Name): LITTLE SISTERS OF THE POOR HOME FOR THE AGED INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/14/2005
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1655 MCGILL AVE
MOBILE AL
36604-1218
US
IV. Provider business mailing address
1655 MCGILL AVE
MOBILE AL
36604-1218
US
V. Phone/Fax
- Phone: 251-476-6335
- Fax: 251-478-6519
- Phone: 251-476-6335
- Fax: 251-478-6519
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GINGER
REBECCA
LYNDALL
Title or Position: RESIDENT SERVICES COORDINATOR
Credential:
Phone: 251-476-6335