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HBR CAMPBELL LANE LLC NPI 1144331216


NPI Information

NPI: 1144331216
Provider Name: HBR CAMPBELL LANE, LLC

Doing Business As: MAGNOLIA VILLAGE

Classification: Alzheimer Center (Dementia Center) - 311500000X
Entity Type: Organization

CLIA Number: 18D1060234

Address:
1381 CAMPBELL LN
BOWLING GREEN, KY
ZIP 42104
Phone: (270) 843-0587
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HBR CAMPBELL LANE, LLC is an alzheimer center dementia center in Bowling Green, KY. The provider is 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. HBR CAMPBELL LANE, LLC NPI is 1144331216. The provider is registered as an organization entity type.
The provider Is Doing Business As Magnolia Village.

The provider's business location address is:

1381 CAMPBELL LN
BOWLING GREEN, KY
ZIP 42104-049
Phone: (270) 843-0587
Fax: (270) 843-0874

The provider's authorized official is Michael T Berg .
The authorized official title is Assistant Secretary and has the following contact phone number (505) 821-3355.

The CLIA number assigned to this NPI record is 18D1060234 - skilled nursing/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/31/2006 and was last updated on 8/25/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1311500000XAlzheimer Center (Dementia Center)KENTUCKYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
17100002190MEDICAIDKENTUCKY
2185435MEDICARE OSCAR/CERTIFICATION
312503348MEDICAIDKENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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.