- Enrollment id
- O20260415002559
- Enrollment state
- AL
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1639048630
- Multiple npi flag
- N
- Ccn
- 015217
- Associate id
- 6305312505
- Organization name
- BIRMINGHAM SNF OPCO LLC
- Doing business as name
- BIRMINGHAM REHABILITATION AND WELLNESS CENTER
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- BIRMINGHAM NURSING AND REHABILITATION CTR LLC
- Affiliation entity name
- LEGACY HEALTHCARE
- Affiliation entity id
- 306
- Address line 1
- 1000 DUGAN AVE
- City
- BIRMINGHAM
- State
- AL
- Zip code
- 352144326