| Name: | Diversicare Windsor House, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Limited Liability Company |
| Status: | Exists |
| Date of registration: | 26 Jul 2000 (25 years ago) |
| Entity Number: | 000-602-658 |
| Register Number: | 000602658 |
| ZIP code: | 36104 |
| County: | Montgomery |
| Place of Formation: | Delaware |
| Principal Address: | 277 MALLORY STATION RD STE 130FRANKLIN, TN 37067 |
| Registered Office Street Address: | 641 SOUTH LAWRENCE STREETMONTGOMERY, AL 36104 |
Activities
OWN AND OPERATE A LONG TERM CARE FACILITY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1902894645 | 2005-10-06 | 2023-04-07 | 1621 GALLERIA BLVD, BRENTWOOD, TN, 370272926, US | 4411 MCALLISTER DR SW, HUNTSVILLE, AL, 358053205, US | |||||||||||||||||||||||||||||
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| Phone | +1 615-550-9453 |
| Fax | 6159156935 |
| Phone | +1 256-837-8585 |
| Fax | 2568372214 |
Authorized person
| Name | MATTHEW J WEISHAAR |
| Role | CHIEF FINANCIAL OFFICER |
| Phone | 6155509459 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | N4507 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 47-57870S |
| State | AL |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY INC | Agent | 251 LITTLE FALLS DRIVEWILMINGTON, DE 19808 |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
