Healthcare Provider Details

I. General information

NPI: 1518679489
Provider Name (Legal Business Name): CHARLESTON PLACE AT NEW ALBANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2022
Last Update Date: 12/22/2022
Certification Date: 12/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4915 CHARLESTOWN RD
NEW ALBANY IN
47150-9426
US

IV. Provider business mailing address

1050 CHINOE RD STE 350
LEXINGTON KY
40502-6571
US

V. Phone/Fax

Practice location:
  • Phone: 812-945-5221
  • Fax:
Mailing address:
  • Phone: 859-255-0075
  • Fax: 859-281-5150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: BRENDA CAMPBELL
Title or Position: AR BILLING MANAGER
Credential:
Phone: 859-255-0075