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General NPI Number Information
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NPI Number | 1730166588
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Entity Type | Organization
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Legal Business Name | CONGRESS STREET PARTNERS, L.P.
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Dates
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Enumeration Date | 12/22/2005
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 550 CONGRESS ST
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City | MOBILE
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State | AL
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Zip | 36603-6152
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Country | US
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Telephone | 251-433-5471
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Fax | 251-433-5476
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Provider Business Mailing Address
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Address Line | 550 CONGRESS ST
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City | MOBILE
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State | AL
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Zip | 36603-6152
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Country | US
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Telephone | 251-433-5471
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Fax | 251-433-5476
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Authorized Official
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Title or Position | REGISTERED AGENT / LEGAL ASSISTANT
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Name | SANDRA L AVALLONE
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Credential |
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Telephone | 678-987-3707
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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 | 11205
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License Number State | AL
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