18D1060234 CLIA NUMBER - HBR CAMPBELL LANE, LLC DBA MAGNOLIA VILLAGE CARE AND REHABILITATION CENTER

Laboratory Demographics

CLIA Number: 18D1060234

Facility Name: HBR CAMPBELL LANE, LLC DBA MAGNOLIA VILLAGE CARE AND REHABILITATION CENTER

Facility Address:
1381 CAMPBELL LANE
BOWLING GREEN, KY
ZIP 42104
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Facility Phone Number: 270 843-0587

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1144331216

Taxonomy: 311500000X - Alzheimer Center (Dementia Center)
A freestanding facility or special care unit of a long term care facility focusing on patient care of individuals diagnosed with dementia or Alzheimer's Disease or their related diseases. Six elements of the facility/unit set it apart from other (the rest of the) facilities(y): Admission of residents with dementia (including those with Alzheimer's disease); Staff who are specially selected, trained, and supervised; Activities that are specifically designed for the cognitively impaired; A marketing of a special care unit in brochures; A high level of family involvement; and A physical environment designed to keep residents safe and segregated from other populations.

CLIA Record

Field Name	Field Value
CLIA Number	18D1060234
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	HBR CAMPBELL LANE, LLC DBA MAGNOLIA VILLAGE CARE AND REHABILITATION CENTER
Street	1381 CAMPBELL LANE
City	BOWLING GREEN
State	KY
ZIP	42104
Phone	270 843-0587
CertificateType	4
CertificateEffectiveDate	10/18/2022
CertificateExpirationDate	10/17/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024