Provider Demographics
NPI:1023440153
Name:RIDGEWOOD HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:RIDGEWOOD HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLEY BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-221-9111
Mailing Address - Street 1:903 11TH ST NE
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35504-8821
Mailing Address - Country:US
Mailing Address - Phone:205-221-9111
Mailing Address - Fax:205-387-1912
Practice Address - Street 1:201 OAKHILL RD
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35504-7496
Practice Address - Country:US
Practice Address - Phone:205-221-4862
Practice Address - Fax:205-384-6404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-31
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility