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General NPI Number Information
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NPI Number | 1063465052
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Entity Type | Organization
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Legal Business Name | GOODWATER HEALTHCARE CENTER LLC
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 16 JONES HILL RD
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City | GOODWATER
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State | AL
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Zip | 35072-9463
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Country | US
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Telephone | 256-839-6711
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Fax | 256-839-6707
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Provider Business Mailing Address
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Address Line | 16 JONES HILL RD
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City | GOODWATER
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State | AL
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Zip | 35072-9463
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Country | US
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Telephone | 256-839-6711
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Fax | 256-839-6707
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Authorized Official
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Title or Position | BILLING OFFICE MANAGER
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Name | LADONNA CHAMBERS
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Credential |
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Telephone | 256-839-6711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 12510
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License Number State | AL
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