Healthcare Provider Details

I. General information

NPI: 1073651295
Provider Name (Legal Business Name): RURAL EDUCATIONAL ASSOCIATION OF KENTUCKY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 07/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 W HIGHWAY 146
PEWEE VALLEY KY
40056-9155
US

IV. Provider business mailing address

7400 W HIGHWAY 146 P. O. BOX 0307
PEWEE VALLEY KY
40056-9155
US

V. Phone/Fax

Practice location:
  • Phone: 502-241-8821
  • Fax: 502-241-4598
Mailing address:
  • Phone: 502-241-8821
  • Fax: 502-241-4598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number100355
License Number StateKY

VIII. Authorized Official

Name: MR. LESLIE J BUTTERFIELD
Title or Position: ADMINISTRATOR
Credential:
Phone: 502-241-8821