NPI 1205096500 · live from the CMS NPI Registry
Al Willow Tree, LLC
Skilled Nursing Facility in Butler, AL. National Provider Identifier 1205096500, active.
NPI record
| NPI | 1205096500 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Skilled Nursing Facility 314000000X |
| Practice location | 1406 E Pushmataha St, Butler, AL 36904 |
| Practice phone | 205-459-5506 |
| Mailing address | 40 Palafox Pl, Ste 400, Pensacola, FL 32502 |
| Enumerated | June 11, 2008 |
| Last updated | October 5, 2015 |
| Authorized official | James Richardson, President |
| Other names | Willow Trace Health And Rehabilitation Center |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Skilled Nursing Facility primary | 314000000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.