01D0304772 CLIA NUMBER - DBA CENTERWELL HOME HEALTH

Laboratory Demographics

CLIA Number: 01D0304772

Facility Name: DBA CENTERWELL HOME HEALTH

Facility Address:
1239 RUCKER BLVD
ENTERPRISE, AL
ZIP 36330
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Facility Phone Number: (334) 347-0234

Facility Type: HOME HEALTH AGENCY

Certificate Type: Waiver

NPI Number: 1174552939

Taxonomy: 251E00000X - Home Health
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

Field Name	Field Value
CLIA Number	01D0304772
LAB Type	HOME HEALTH AGENCY
Facility Name	DBA CENTERWELL HOME HEALTH
Street	1239 RUCKER BLVD
City	ENTERPRISE
State	AL
ZIP	36330
Phone	(334) 347-0234

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Laboratory Demographics

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