Healthcare Provider Details

I. General information

NPI: 1588049019
Provider Name (Legal Business Name): BRIGHTON CORNERSTONE GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2015
Last Update Date: 12/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 E NORTH ST
MADISONVILLE KY
42431-1643
US

IV. Provider business mailing address

55 E NORTH ST
MADISONVILLE KY
42431-1643
US

V. Phone/Fax

Practice location:
  • Phone: 270-821-1492
  • Fax: 270-821-6946
Mailing address:
  • Phone: 270-821-1492
  • Fax: 270-821-6946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number100183
License Number StateKY

VIII. Authorized Official

Name: MRS. KIMBERLY D SMITH
Title or Position: CFO/OWNER
Credential: NHA
Phone: 731-588-4302