Healthcare Provider Details

I. General information

NPI: 1497243455
Provider Name (Legal Business Name): LANDMARK OF ELKHORN CITY REHABILITATION AND NURSING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2018
Last Update Date: 10/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 W RUSSELL ST
ELKHORN CITY KY
41522-9032
US

IV. Provider business mailing address

6101 NIMTZ PKWY
SOUTH BEND IN
46628-6111
US

V. Phone/Fax

Practice location:
  • Phone: 606-754-4134
  • Fax:
Mailing address:
  • Phone: 269-281-4200
  • Fax:

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: JOSEPH MEISELS
Title or Position: MANAGER
Credential:
Phone: 269-281-4200