Healthcare Provider Details

I. General information

NPI: 1417071663
Provider Name (Legal Business Name): CARDINAL HILL REHABILITATION HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 VERSAILLES ROAD
LEXINGTON KY
40511
US

IV. Provider business mailing address

697 KENOVA TRACE
LEXINGTON KY
40511
US

V. Phone/Fax

Practice location:
  • Phone: 859-254-5701
  • Fax:
Mailing address:
  • Phone: 859-420-1185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License NumberKY-1168
License Number StateKY

VIII. Authorized Official

Name: MS. MARY JANE WHITE
Title or Position: REGISTERED DIETITIAN
Credential: MS, RD, LD
Phone: 859-254-5701