Healthcare Provider Details

I. General information

NPI: 1518413889
Provider Name (Legal Business Name): KENTON HOUSING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2016
Last Update Date: 08/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3802 TURKEYFOOT ROAD
ELSMERE KY
41018
US

IV. Provider business mailing address

4250 GLENN AVENUE
COVINGTON KY
41015
US

V. Phone/Fax

Practice location:
  • Phone: 859-342-0200
  • Fax:
Mailing address:
  • Phone: 859-431-2244
  • Fax: 859-431-7790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: LONDA LEAH KNOLLMAN
Title or Position: EXECUTIVE DIRECTOR
Credential: LNHA
Phone: 859-431-2244