NPI 1306833694 · live from the CMS NPI Registry
Diversicare Leasing Lp
Skilled Nursing Facility in Phenix City, AL. National Provider Identifier 1306833694, active.
NPI record
| NPI | 1306833694 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Skilled Nursing Facility 314000000X |
| Practice location | 1720 Knowles Rd, Phenix City, AL 36869 |
| Practice phone | 334-291-0486 |
| Enumerated | October 1, 2005 |
| Last updated | October 25, 2022 |
| Authorized official | Matthew Weishaar, Chief Financial Officer & Secretary |
| Other names | Canterbury Healthcare Facility |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Skilled Nursing Facility primary | 314000000X | N5704 (AL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.