Healthcare Provider Details

I. General information

NPI: 1295620847
Provider Name (Legal Business Name): MENIFEE MEADOWS NURSING & REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2025
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 BERRYMAN RD
FRENCHBURG KY
40322-8496
US

IV. Provider business mailing address

PO BOX 1667
HICKORY NC
28603-1667
US

V. Phone/Fax

Practice location:
  • Phone: 606-768-9001
  • Fax: 606-768-9005
Mailing address:
  • Phone: 828-324-8898
  • 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: BRYON D WOMACK
Title or Position: SOLE MEMBER
Credential:
Phone: 828-334-5323