Healthcare Provider Details
I. General information
NPI: 1437682309
Provider Name (Legal Business Name): LANDMARK OF LANCASTER REHABILITATION AND NURSING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/07/2017
Last Update Date: 04/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
308 W MAPLE AVE
LANCASTER KY
40444-1005
US
IV. Provider business mailing address
308 W MAPLE AVE
LANCASTER KY
40444-1005
US
V. Phone/Fax
- Phone: 859-792-6844
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | 100719 |
| License Number State | KY |
VIII. Authorized Official
Name:
JOSEPH
MEISELS
Title or Position: MBR
Credential:
Phone: 718-664-5400