Healthcare Provider Details

I. General information

NPI: 1487139705
Provider Name (Legal Business Name): WOODCREST OPERATING COMPANY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2018
Last Update Date: 09/01/2022
Certification Date: 09/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3876 TURKEYFOOT RD
ELSMERE KY
41018-2838
US

IV. Provider business mailing address

3876 TURKEYFOOT RD
ELSMERE KY
41018-2838
US

V. Phone/Fax

Practice location:
  • Phone: 859-342-8775
  • Fax: 859-342-8701
Mailing address:
  • Phone: 859-342-8775
  • Fax: 859-342-8701

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: MOSHE KELMAN
Title or Position: MANAGING MEMBER
Credential:
Phone: 859-342-8775