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General NPI Number Information
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NPI Number | 1053370544
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Entity Type | Organization
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Legal Business Name | CROWNE HEALTH CARE OF GREENVILLE, LLC
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Dates
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Enumeration Date | 03/22/2006
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Last Update Date | 03/06/2024
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Provider Practice Location Address
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Address Line | 408 COUNTRY CLUB DR
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City | GREENVILLE
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State | AL
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Zip | 36037-1310
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Country | US
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Telephone | 334-382-2693
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Fax | 334-382-8579
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Provider Business Mailing Address
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Address Line | 501 WHETSTONE ST
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City | MONROEVILLE
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State | AL
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Zip | 36460-2615
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Country | US
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Telephone | 251-743-3609
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Fax | 251-575-5618
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Authorized Official
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Title or Position | CFO
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Name | NOEL DUNNAM
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Credential |
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Telephone | 251-743-7137
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 12485
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License Number State | AL
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