| Name: | Mobile Nursing and Rehabilitation Center, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 07 May 2003 (22 years ago) |
| Entity Number: | 000-689-937 |
| Register Number: | 000689937 |
| ZIP code: | 36104 |
| County: | Montgomery |
| Place of Formation: | Montgomery County |
| Principal Address: | MONTGOMERY, AL |
| Registered Office Mailing Address: | 444 S PERRY STMONTGOMERY, AL 36104-0347 |
| Registered Office Street Address: | 444 S PERRY STMONTGOMERY, AL 36104 |
Activities
OPERATE/MANAGE HEALTH CARE FACILITIES/SKILLED NURSING SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1063521748 | 2006-08-29 | 2023-12-08 | PO BOX 428, ORCHARD PARK, NY, 141270428, US | 7020 BRUNS DR, MOBILE, AL, 366954329, US | |||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 716-662-4955 |
| Fax | 7166679230 |
| Phone | +1 251-639-1588 |
| Fax | 2516398278 |
Authorized person
| Name | MR. NORBERT A BENNETT |
| Role | CO-CEO |
| Phone | 7166624955 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | 12643 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | UHC MEDICARE COMPLETE |
| Number | 7100010 |
| State | AL |
| Issuer | MEDICAID |
| Number | 4757550S |
| State | AL |
| Issuer | BC/BS OF ALABAMA |
| Number | 00384 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| GILL, RICHARD H | Agent | 444 SOUTH PERRY STREETMONTGOMERY, AL 36101 |
| Name | Role |
|---|---|
| LKC LLC | Member |
| D & N LLC | Member |
| DTD HC LLC | Member |
| Inspection Nr | Report ID | Date Opened | Site Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 311612329 | 0418600 | 2008-02-12 | 7020 BRUNS DRIVE, MOBILE, AL, 36695 | |||||||||||||||||||||||||||||||
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| Citation ID | 01001 |
| Citaton Type | Other |
| Standard Cited | 19101030 C01 IV |
| Issuance Date | 2008-04-30 |
| Abatement Due Date | 2008-05-27 |
| Nr Instances | 1 |
| Nr Exposed | 30 |
| Gravity | 01 |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
