| NPI | 1639310881 |
|---|---|
| Doing Business As | PROVIDENCE PAVILION |
| Entity Type | Organization |
| Authorized Contact | GEORGE S HAGAN Manager 859-261-5231 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: KY 100266) |
| Enumeration Date | 2009-03-18 |
| Last Update Date | 2010-01-22 |