Healthcare Provider Details

I. General information

NPI: 1669558086
Provider Name (Legal Business Name): ST. CLAIR HEALTH & REHAB, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 12/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 HWY 78E
PELL CITY AL
35128
US

IV. Provider business mailing address

7300 HIGHWAY 78E
PELL CITY AL
35128
US

V. Phone/Fax

Practice location:
  • Phone: 205-640-5212
  • Fax: 205-640-7782
Mailing address:
  • Phone: 205-640-5212
  • Fax: 205-640-7782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number12673
License Number StateAL

VIII. Authorized Official

Name: MRS. JUDY GANT
Title or Position: ADMINISTRATOR
Credential:
Phone: 205-640-5212