| NPI | 1841625662 |
|---|---|
| Doing Business As | DIVERSICARE OF PROVIDENCE |
| Doing Business As | CHARLESTOWN PLACE AT NEW ALBANY |
| Entity Type | Organization |
| Authorized Contact | BRENDA CAMPBELL Delegated Official 859-255-0075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: IN 16-001144-1) |
| Enumeration Date | 2013-09-11 |
| Last Update Date | 2024-01-12 |