| NPI | 1023110400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI M GRAY Accounts Receivable / Billing 270-388-2291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: KY 100300) |
| Additional Taxonomies | 311Z00000X Custodial Care Facility (Licence: KY 100300) |
| 313M00000X Nursing Facility/Intermediate Care Facility (Licence: KY 100300) | |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2007-12-27 |