PROVIDENCE HEALTHCARE OF HOMESTEAD, LLC - NPI NUMBER 1114343647

Summary

Provider Name: PROVIDENCE HEALTHCARE OF HOMESTEAD, LLC

NPI Number: 1114343647

Clasification: Skilled Nursing Facility (314000000X)

Address:
1608 VERSAILLES RD
LEXINGTON, KY
ZIP 40504

Phone Number: (859) 252-0871



Detailed Information

PROVIDENCE HEALTHCARE OF HOMESTEAD, LLC is a skilled nursing facility in Lexington, KY. The provider is (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. The assigned NPI number for this provider is 1114343647 and is registered as an organization entity type.

The provider's business address is:

1608 VERSAILLES RD
LEXINGTON, KY
ZIP 40504-402
Phone: (859) 252-0871

The provider's authorized official is Jason Murray .
The authorized official title is President & Ceo and has the following contact phone number (801) 721-3433.

The enumeration date for this NPI number is 3/7/2014 and was last updated on 3/7/2014.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 314000000X Skilled Nursing Facility Yes

NPI Record

No. Field Name Field Value
1 NPI 1114343647
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name PROVIDENCE HEALTHCARE OF HOMESTEAD, LLC
5 Provider First Line Business Practice Location Address 1608 VERSAILLES RD
6 Provider Business Practice Location Address City Name LEXINGTON
7 Provider Business Practice Location Address State Name KY
8 Provider Business Practice Location Address Postal Code 405042402
9 Provider Business Practice Location Address Country Code If outside U S US
10 Provider Business Practice Location Address Telephone Number 8592520871
11 Provider Enumeration Date 3/7/2014
12 Last Update Date 3/7/2014
13 Authorized Official Last Name MURRAY
14 Authorized Official First Name JASON
15 Authorized Official Title or Position PRESIDENT & CEO
16 Authorized Official Telephone Number 8017213433
17 Healthcare Provider Taxonomy Code 1 314000000X
18 Healthcare Provider Primary Taxonomy Switch 1 Y
19 Is Organization Subpart N

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This page was last updated on: 7/15/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.