Healthcare Provider Details

I. General information

NPI: 1033828124
Provider Name (Legal Business Name): APPALACHIAN POST ACUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2022
Last Update Date: 11/30/2022
Certification Date: 11/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 JETT DR
JACKSON KY
41339-9621
US

IV. Provider business mailing address

851 NE 1ST AVE UNIT 701
MIAMI FL
33132-1835
US

V. Phone/Fax

Practice location:
  • Phone: 606-666-2456
  • Fax:
Mailing address:
  • Phone:
  • 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: KENNETH FUNK
Title or Position: MANAGER
Credential:
Phone: 606-666-2456