Healthcare Provider Details

I. General information

NPI: 1043205065
Provider Name (Legal Business Name): HOMESTEAD NURSING & REHAB CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1608 VERSAILLES RD
LEXINGTON KY
40504-2402
US

IV. Provider business mailing address

1608 VERSAILLES RD
LEXINGTON KY
40504-2402
US

V. Phone/Fax

Practice location:
  • Phone: 859-252-0871
  • Fax: 859-389-9571
Mailing address:
  • Phone: 859-252-0871
  • Fax: 859-389-9571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3140N1450X
TaxonomyPediatric Skilled Nursing Facility
License Number
License Number StateKY

VIII. Authorized Official

Name: MRS. DENISE N/A COOLEY
Title or Position: LPN-ADMISSION COORDINATOR
Credential: LPN-AC
Phone: 859-252-0871