=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831471507
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALL WELL HOME HEALTH CARE INCORPORATED
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/19/2011
-----------------------------------------------------
Last Update Date | 11/30/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1150 INVERNESS COVE WAY
-----------------------------------------------------
City | BIRMINGHAM
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35242-4262
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-914-1582
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1150 INVERNESS COVE WAY
-----------------------------------------------------
City | BIRMINGHAM
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35242-4262
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-914-1582
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PARTNER
-----------------------------------------------------
Name | LIA KRISTEN MITCHELL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 205-522-8236
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 1117370
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------