Wilder Health Care Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

12687 Issued in AL

Legal business name

WILDER HEALTH CARE CENTER, LLC

Practice address

345 E Lafayette St
Dadeville, AL 36853-1415

Phone

(256) 825-7881

Fax

(256) 825-7772

NPI assigned

Dec 6, 2006

Last updated

Feb 21, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Janice Tyler, ADMINISTRATOR

Title

Administrator

Phone

(256) 825-7881

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203552000000",
    "number": "1013076025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 E LAFAYETTE ST",
            "city": "DADEVILLE",
            "state": "AL",
            "postal_code": "368531415",
            "telephone_number": "256-825-7881",
            "fax_number": "256-825-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 E LAFAYETTE ST",
            "city": "DADEVILLE",
            "state": "AL",
            "postal_code": "368531415",
            "telephone_number": "256-825-7881",
            "fax_number": "256-825-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILDER HEALTH CARE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2008-02-21",
        "status": "A",
        "authorized_official_last_name": "TYLER",
        "authorized_official_first_name": "JANICE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "256-825-7881",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AL",
            "license": "12687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4756800S",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Ann Toledo
• Casey Turner, PHARMD
• Walgreen Co (Walgreens #18374)
• Brittany Welch
• Autumn White
• Barbara Wilder, CRNP
• Nidra Wilson Thomas, PMHNP

• Skilled Nursing Facility in Dadeville, AL
• Providers in Dadeville, AL by specialty
• Skilled Nursing Facility in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.