| Name: | South Hampton Nursing & Rehabilitation Center, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 19 Feb 2002 (23 years ago) |
| Entity Number: | 000-680-442 |
| Register Number: | 000680442 |
| ZIP code: | 35960 |
| County: | Cherokee |
| Place of Formation: | Cherokee County |
| Principal Address: | 230 WEST MAIN STREETCENTRE, AL 35960 |
Activities
NURSING HOME/REHABILITATION FACILITY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1598752073 | 2005-09-30 | 2015-05-13 | 213 WILSON MANN RD, OWENS CROSS ROADS, AL, 357638606, US | 213 WILSON MANN RD, OWENS CROSS ROADS, AL, 357638606, US | |||||||||||||||||||||||||
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| Phone | +1 256-725-3400 |
| Fax | 2567253423 |
Authorized person
| Name | MRS. MONTE S STICKLER |
| Role | REGIONAL ACCT. |
| Phone | 2566773819 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | 10596 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 4758120S |
| State | AL |
| Name | Role | Address |
|---|---|---|
| WALKER, JAMES P JR | Agent | 230 WEST MAIN STREETCENTRE, AL 35960 |
| Name | Role | Address |
|---|---|---|
| WALKER, JAMES P JR | Member | 230 WEST MAIN STREETCENTRE, AL 35960 |
| Name | Role | Address |
|---|---|---|
| WALKER, JAMES P JR | Organizer | 230 WEST MAIN STREETCENTRE, AL 35960 |
| Contract Type | Award or IDV Flag | PIID | Start Date | Current End Date | Potential End Date | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DO | AWARD | V674C85373 | 2004-08-18 | 2007-08-17 | 2009-08-17 | |||||||||||||||||||
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| Title | NURSING HOME |
| Product and Service Codes | Q402: NURSING HOME CARE CONTRACTS |
Recipient Details
| Recipient | SOUTH HAMPTON NURSING & REHABILITATION CENTER, LLC |
| UEI | CK5QEJM831X5 |
| Legacy DUNS | 134513006 |
| Recipient Address | UNITED STATES, 213 WILSON MANN ROAD, OWENS CROSS ROADS, 357638606 |
| Unique Award Key | CONT_AWD_VA674C85204_3600_V247P1405_3600 |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Description
| Title | NURSING HOME |
| Product and Service Codes | Q402: NURSING HOME CARE CONTRACTS |
Recipient Details
| Recipient | SOUTH HAMPTON NURSING & REHABILITATION CENTER, LLC |
| UEI | CK5QEJM831X5 |
| Legacy DUNS | 134513006 |
| Recipient Address | UNITED STATES, 213 WILSON MANN ROAD, OWENS CROSS ROADS, 357638606 |
| Inspection Nr | Report ID | Date Opened | Site Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 316434141 | 0418300 | 2012-04-10 | 213 WILSON MANN ROAD, OWENS CROSS ROADS, AL, 35763 | |||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Citation ID | 01001 |
| Citaton Type | Serious |
| Standard Cited | 19100022 A01 |
| Issuance Date | 2012-05-02 |
| Abatement Due Date | 2012-06-06 |
| Current Penalty | 1260.0 |
| Initial Penalty | 2100.0 |
| Nr Instances | 1 |
| Nr Exposed | 2 |
| Gravity | 01 |
| Citation ID | 02001 |
| Citaton Type | Other |
| Standard Cited | 19101030 C01 IVB |
| Issuance Date | 2012-05-02 |
| Abatement Due Date | 2012-05-08 |
| Nr Instances | 1 |
| Nr Exposed | 60 |
| Gravity | 01 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 5603287010 | 2020-04-06 | 0459 | PPP | 213 WILSON MANN RD, OWENS CROSS ROADS, AL, 35763-8606 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
