DIVERSICARE OF BOAZ, LLC (NPI# 1396290466) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396290466 |
| Entity Type | Organization |
| Organization Name | DIVERSICARE OF BOAZ, LLC |
| Other Organization Name | DIVERSICARE OF BOAZ |
| Practice Address |
600 Corley Ave Boaz AL 35957-5952 |
| Practice Telephone | 2565938380 |
| Practice Fax Number | 6156207875 |
| Mailing Telephone | 2565938380 |
| Mailing Fax Number | 6156207875 |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2016-08-18 |
| Authorized Official Name | KELLY J GILL (CEO) |
| Authorized Official Telephone | 6157717575 |
| Is Organization Subpart | Y |
| Parent Organization Name | DIVERSICARE LEASING COMPANY III, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | AL | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Diversicare of Boaz | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Alabama Business Registrations | Diversicare of Boaz, LLC | 1621 Galleria Boulevard, Brentwood, TN 37027 |
| Street Address |
600 CORLEY AVE |
| City | BOAZ |
| State | AL |
| Zip Code | 35957-5952 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588615298 | Ggnsc Boaz LLC | Skilled Nursing Facility | 600 Corley Ave, Boaz, AL 35957-5952 | 2006-05-15 |
| 1730438292 | Benjamin L Jenkins | Physical Therapist | 600 Corley Ave, Boaz, AL 35957-5952 | 2012-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124639935 | Twindom Counseling Services, LLC | Community/Behavioral Health | 202 Lackey Street, Boaz, AL 35957 | 2020-08-14 |
| 1407464308 | Brittany C Mcclendon | Nurse Practitioner | 2505 Us Hwy. 431, Suite A, Women's Center, Boaz, AL 35957 | 2020-07-16 |
| 1942831169 | Kayleigh Danielle Eller | Student in an Organized Health Care Education/Training Program | 147 Stephans Road, Boaz, AL 35957 | 2020-01-27 |
| 1710443767 | Antallia Shauntell Johnson | Nurse Practitioner | 2505 Us Hwy 431 Women's Center Suite A, Boaz, AL 35957 | 2019-02-14 |
| 1649516659 | Tiffany Brown Butler | Nurse Practitioner | 2505 U.S. Highway 431, Boaz, AL 35957 | 2012-12-19 |
| 1811263270 | Abundant Life Family Chiropractic LLC | Chiropractor | 100 Bel Air St, Boaz, AL 35957 | 2012-03-29 |
| 1659696375 | Rachel Lambert | Pharmacist | 10402 Al Hwy 168, Boaz, AL 35957 | 2010-04-06 |
| 1407028368 | Brenda J Parrish | Nurse Practitioner | 2505highway 431, Boaz, AL 35957 | 2008-03-31 |
| 1942346234 | Candi Denise Blackwell | Nurse Anesthetist, Certified Registered | 2055 Us Hwy 431, Boaz, AL 35957 | 2007-01-30 |
| 1558418426 | Gideon P Ewing | Internal Medicine | 2505 Highway 431, Boaz, AL 35957 | 2007-01-04 |
| Find all providers in zip 35957 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588615298 | Ggnsc Boaz LLC | Skilled Nursing Facility | 600 Corley Ave, Boaz, AL 35957-5952 | 2006-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790268068 | Goodwater Healthcare Center | Skilled Nursing Facility | 16 Jones Hill Rd, Goodwater, AL 35072-9463 | 2018-09-12 |
| 1124574843 | Hair To Go | Skilled Nursing Facility | 4097 Somerset Ridge, Birmingham, AL 35242 | 2016-09-01 |
| 1679027841 | Aspire Physical Recovery Center At Cahaba River, LLC | Skilled Nursing Facility | 3070 Healthy Way, Vestavia, AL 35243 | 2016-08-05 |
| 1851785844 | Selena Duff | Skilled Nursing Facility | 2830 Phillips St, Florence, AL 35633-1525 | 2015-03-27 |
| 1285038398 | Aspire Physical Recovery Center At Hoover, LLC | Skilled Nursing Facility | 575 Southland Dr, Hoover, AL 35226-3732 | 2014-10-17 |
| 1417360819 | Katrina Lovill | Skilled Nursing Facility | 1716 Ballard Dr Se, Huntsville, AL 35801-1619 | 2014-06-04 |
| 1023440153 | Ridgewood Health Services, Inc. | Skilled Nursing Facility | 201 Oakhill Rd, Jasper, AL 35504-7496 | 2013-07-31 |
| 1366700528 | Bkd Alabama Snf LLC | Skilled Nursing Facility | 501 University Park Drive, Birmingham, AL 35209-6738 | 2012-04-25 |
| 1225347495 | Montgomery Children's Specialty Center, LLC | Skilled Nursing Facility | 2853 Forbes, Montgomery, AL 36110-1307 | 2010-10-05 |
| 1407081557 | Stacie Peek Wilson | Skilled Nursing Facility | 2701 Meridian Street North, Huntsville, AL 35811 | 2009-05-19 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.