NPIMap

Organization Active NPI

South Haven Health and Rehabilitation, LLC

  • Skilled Nursing Facility
  • Hoover, AL
National Provider Identifier
1083661821
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SOUTH HAVEN HEALTH AND REHABILITATION, LLC
Practice address
3141 Old Columbiana Rd
Hoover, AL 35226-3703
Phone
(205) 822-1580
NPI assigned
May 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Authorized official

Name
Phillip Cody Long
Title
Cfo
Phone
(205) 391-3600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

3141 Old Columbiana Rd
Hoover, AL 35226-3703

Mailing address

3141 Old Columbiana Rd
Hoover, AL 35226-3703
Phone (205) 822-1580

Other identifiers 2

IdentifierTypeStateIssuer
012650OtherALBCBS ID
4753210SMedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050201000497 AL Part A Provider - Skilled Nursing Facility 3779534383 Practice locations: Hoover, AL

Skilled nursing facility certification: CCN 015321

Legal name
SOUTH HAVEN HEALTH AND REHABILITATION LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 1, 1971
Last certification
Jul 14, 2022
Beds
101
Ownership / control type
Individual
Multi-facility organization
NHS MANAGEMENT
Most recent change of ownership
Jan 1, 2005
Organization structure
LLCProprietary
Enrollment address
3141 Old Columbiana Rd
Hoover, AL 35226-3703
Nursing home name
SOUTH HAVEN HEALTH AND REHABILITATION, LLC
Affiliated entity
NHS MANAGEMENT

Care Compare: Nursing home

Medicare Care Compare
Listed as
South Haven Health and Rehabilitation, LLCCCN 015321
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Individual
Certified
Nov 1, 1971
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10196.4 residents per day on average
Chain
NHS Management43 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D1037236South Haven Health and Rehabilitation3141 Old Columbiana Road, Hoover, AL 35226Certificate of waiverFeb 17, 2027

National Provider Directory

National Provider Directory

Locations

3141 Old Columbiana Rd
Hoover, AL 35226
Phone (205) 822-1580

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
James Norman Estes Jr TR Organization, Vestavia, AL 5% Or Greater Indirect Ownership Interest Jul 1, 2013 6.25%
Lynn S Rasco Individual Corporate DirectorDirector of Qa/Corp Compliance Ofcr Jul 29, 2013 33%
Operational/Managerial ControlDirector of Qa/Corp Compliance Ofcr Jul 29, 2013 33%
South Haven Health Realty LLC Organization, Tuscaloosa, AL LLC, For-profit, Owned by another organization or individual 5% Or Greater Security Interest Dec 16, 2024
Adp of the SNF Dec 16, 2024
Jennifer Lee Estes TR 031093 Organization, Vestavia, AL 5% Or Greater Indirect Ownership Interest Jul 1, 2013 6.25%
James Norman Estes Individual 5% Or Greater Indirect Ownership InterestPresident/Treasurer Nov 19, 2004 51%
Corporate OfficerPresident/Treasurer Nov 19, 2004 100%
Phillip Cody Long Individual Corporate OfficerVice President/Secretary Oct 1, 2019
Jennifer E Agee Family Dynasty TR No 2 Organization, Tuscaloosa, AL 5% Or Greater Indirect Ownership Interest Jan 1, 2013 18.25%
Hilary R. Morris Individual Corporate DirectorRegional Nurse Consultant Sep 1, 2023 33%
Operational/Managerial ControlRegional Nurse Consultant Sep 1, 2023 33%
Northport Holding Operations, LLC Organization, Tuscaloosa, AL LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest Nov 19, 2004 100%
Hilton S Jordan Individual Operational/Managerial Control Oct 14, 2024
Adp of the SNF Feb 5, 2025
James N Estes Jr Family Dynasty TR No 2 Organization, Tuscaloosa, AL 5% Or Greater Indirect Ownership Interest Jan 1, 2013 18.25%
Regions Bank Organization, Birmingham, AL Financial institution 5% Or Greater Security Interest Aug 27, 2013
Leigh Ann Cobb Individual Corporate DirectorRegional Administrator Jul 24, 2023 33%
Operational/Managerial ControlRegional Administrator Jul 24, 2023 33%

Facilities with the same owner 42

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 42

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603843200000",
    "number": "1083661821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3141 OLD COLUMBIANA RD",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352263703",
            "telephone_number": "205-822-1580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3141 OLD COLUMBIANA RD",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352263703",
            "telephone_number": "205-822-1580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH HAVEN HEALTH AND REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "CODY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "205-391-3600"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID",
            "identifier": "012650",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4753210S",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoover, AL

Sources for this page

Verify at the official NPI Registry.