WOODHAVEN MANOR NURSING HOME, LLC (NPI# 1477512952) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477512952 |
| Entity Type | Organization |
| Organization Name | WOODHAVEN MANOR NURSING HOME, LLC |
| Practice Address |
105 W Windsor St Demopolis AL 36732-3617 |
| Mailing Address |
501 Whetstone St Monroeville AL 36460-2615 |
| Practice Telephone | 3342892741 |
| Practice Fax Number | 3342890416 |
| Mailing Telephone | 2517433609 |
| Mailing Fax Number | 2515755618 |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DAVID G MCABEE (CFO) |
| Authorized Official Telephone | 2517433609 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | 12619 | AL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 4754320S | 05 |
| Street Address |
105 W WINDSOR ST |
| City | DEMOPOLIS |
| State | AL |
| Zip Code | 36732-3617 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912409418 | Tiffanie Elizabeth Lewis | Occupational Therapist | 105 W Windsor St, Demopolis, AL 36732-3617 | 2018-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790336196 | Preferred Eye Care LLC | Optometrist | 931 Highway 80 West, Suite A, Demopolis, AL 36732 | 2019-09-26 |
| 1215454517 | Braxton Senior Care | Day Training/Habilitation Specialist | 307 South Cherry Avenue, Demopolis, AL 36732 | 2017-08-28 |
| 1699206060 | Jamie Lynn Tucker | Pharmacist | 1107 Lillian Lane, Demopolis, AL 36732 | 2017-03-27 |
| 1578717021 | Sheila Bouler Pfaffman | Counselor | 409 North Walnut Avenue, Demopolis, AL 36732 | 2008-11-11 |
| 1609072537 | Southeast Cancer Network, Inc | Internal Medicine | 105 Highway 80 E., Demopolis, AL 36732 | 2007-06-26 |
| 1720102387 | Drs. Ketcham and Dismukes | Durable Medical Equipment & Medical Supplies | 202 Hwy 80 E, Demopolis, AL 36732 | 2007-03-19 |
| 1942356472 | Dana Eddins | Speech-Language Pathologist | 1400 Herbert St, Demopolis, AL 36732 | 2007-01-26 |
| 1083785182 | Mary Juanita Shakes | Social Worker | 205 Herbert Street, Demopolis, AL 36732 | 2006-11-11 |
| 1114006848 | Rural Health Medical Program, Inc | Clinic/Center | 1502 Highway 80 East, Unit A, Demopolis, AL 36732 | 2006-11-03 |
| 1518051788 | Judy Cooke Travis | Emergency Medicine | 123 East Capitol Street, Demopolis, AL 36732 | 2006-10-03 |
| Find all providers in zip 36732 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609077577 | Rtg Medical | Nursing Facility/Intermediate Care Facility | 400 N Ash Ave, Demopolis, AL 36732-2444 | 2007-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467998864 | Advance Med | Nursing Facility/Intermediate Care Facility | 117 Rocky Ridge St, Carrollton, AL 35447-2139 | 2017-01-10 |
| 1568863785 | Mobile Picc Specialists | Nursing Facility/Intermediate Care Facility | 39 Ashwood Rd, Butler, AL 36904-2860 | 2014-09-07 |
| 1740552306 | Oakwoods Dream Care Assisted Living Facility LLC. | Nursing Facility/Intermediate Care Facility | 1008 Oakwood Ave Nw, Huntsville, AL 35811-1661 | 2012-01-29 |
| 1861597114 | Jackson County Healthcare Authority | Nursing Facility/Intermediate Care Facility | 47065 Alabama Hwy 277, Bridgeport, AL 35740 | 2006-09-13 |
| 1154380632 | Crowne Health Care of Mobile, LLC | Nursing Facility/Intermediate Care Facility | 954 Navco Rd, Mobile, AL 36605-2413 | 2006-03-22 |
| 1285693762 | Evergreen Nursing Home, LLC | Nursing Facility/Intermediate Care Facility | 100 Sanders Dr, Evergreen, AL 36401-3306 | 2006-03-22 |
| 1508825076 | Crowne Health Care of Fort Payne, LLC | Nursing Facility/Intermediate Care Facility | 403 13th St Nw, Fort Payne, AL 35967-3145 | 2006-03-22 |
| 1043279532 | Crowne Health Care of Eufaula, LLC | Nursing Facility/Intermediate Care Facility | 430 Rivers Ave, Eufaula, AL 36027-1820 | 2006-03-22 |
| 1659330132 | Parkwood Health Care Facility, LLC | Nursing Facility/Intermediate Care Facility | 3301 Stadium Dr, Phenix City, AL 36867-3115 | 2006-03-22 |
| 1740249200 | Atmore Nursing Center, LLC | Nursing Facility/Intermediate Care Facility | 715 E Laurel St, Atmore, AL 36502-3113 | 2006-03-22 |
| 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.