- Enrollment id
- O20051004001058
- Enrollment state
- AL
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1609872290
- Multiple npi flag
- N
- Ccn
- 015171
- Associate id
- 8426083882
- Organization name
- MAIN AND ASSOCIATES INC
- Doing business as name
- SOUTHERN SPRINGS HEALTHCARE
- Incorporation date
- 1991-07-08
- Incorporation state
- AL
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Nursing home provider name
- SOUTHERN SPRINGS HEALTHCARE FACILITY
- Address line 1
- 745 SOUTHERN SPRINGS RD
- City
- UNION SPRINGS
- State
- AL
- Zip code
- 360896643