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General NPI Number Information
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NPI Number | 1790855211
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Entity Type | Organization
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Legal Business Name | ALICE M KIDD NURSING FACILITY
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 200 UNIVERSITY BLVD
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City | TUSCALOOSA
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State | AL
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Zip | 35402-0707
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Country | US
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Telephone | 205-759-0633
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Fax | 205-759-0133
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Provider Business Mailing Address
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Address Line | PO BOX 20707 200 UNIVERSITY BLVD
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City | TUSCALOOSA
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State | AL
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Zip | 35402-0707
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Country | US
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Telephone | 205-759-0633
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Fax | 205-759-0133
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Authorized Official
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Title or Position | FACILITY DIRECTOR
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Name | MRS. NEDRA MONCRIEF-CRAIG
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Credential | FACILITY DIRECTOR
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Telephone | 205-759-0633
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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 |
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License Number State |
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