Healthcare Provider Details

I. General information

NPI: 1760639843
Provider Name (Legal Business Name): LEXINGTON HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2008
Last Update Date: 10/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

353 WALLER AVE
LEXINGTON KY
40504-2901
US

IV. Provider business mailing address

7400 NEW LAGRANGE RD 100
LOUISVILLE KY
40222-4870
US

V. Phone/Fax

Practice location:
  • Phone: 859-252-3558
  • Fax: 859-233-0192
Mailing address:
  • Phone: 502-429-8062
  • Fax: 502-429-5980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number100113
License Number StateKY

VIII. Authorized Official

Name: ARNOLD PERLSTEIN
Title or Position: MEMBER
Credential:
Phone: 502-429-8062