Healthcare Provider Details

I. General information

NPI: 1336178623
Provider Name (Legal Business Name): BEREA HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 04/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 RICHMOND RD N
BEREA KY
40403-8788
US

IV. Provider business mailing address

601 RICHMOND RD N
BEREA KY
40403-8788
US

V. Phone/Fax

Practice location:
  • Phone: 859-623-0898
  • Fax: 859-623-0843
Mailing address:
  • Phone: 859-623-0898
  • Fax: 859-623-0843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number100319
License Number StateKY

VIII. Authorized Official

Name: MR. STEVE STRUNK
Title or Position: VP OF FINANCE
Credential:
Phone: 859-623-0898