| Name: | Andalusia Health Care, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 14 Oct 1988 (36 years ago) |
| Entity Number: | 000-126-896 |
| Register Number: | 000126896 |
| ZIP code: | 36009 |
| County: | Crenshaw |
| Place of Formation: | Crenshaw County |
| Principal Address: | ANDALUSIA, AL |
| Registered Office Street Address: | RT. 3, BOX 7BRANTLEY, AL 36009 |
| Authorized Capital: | $100 |
| Paid Share Capital: | $100 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538188719 | 2006-07-19 | 2020-08-22 | PO BOX 1395, ANDALUSIA, AL, 364201224, US | 200 HILLCREST DR, ANDALUSIA, AL, 364202527, US | |||||||||||||||||||||||||
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| Phone | +1 334-222-2101 |
| Fax | 3342225653 |
Authorized person
| Name | MS. TRECE MAYS |
| Role | NURSING HOME ADMINISTRATOR |
| Phone | 3342222101 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | 00383 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 4750820S |
| State | AL |
| Name | Role |
|---|---|
| SASSER, G DALE | Agent |
| Name | Role |
|---|---|
| SASSER, G DALE | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
