Provider Demographics
NPI:1023638285
Name:CROWNE HEALTH CARE OF THOMASVILLE,LLC
Entity type:Organization
Organization Name:CROWNE HEALTH CARE OF THOMASVILLE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:NOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNNAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-743-7137
Mailing Address - Street 1:1425 MOSLEY DR
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36784-3334
Mailing Address - Country:US
Mailing Address - Phone:334-636-5614
Mailing Address - Fax:
Practice Address - Street 1:1425 MOSLEY DR
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:AL
Practice Address - Zip Code:36784-3334
Practice Address - Country:US
Practice Address - Phone:334-636-5614
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-17
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility