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NPI 1053422295

NPI 1053422295 : HBR BOWLING GREEN, LLC : BOWLING GREEN, KY

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General NPI Number Information
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    NPI Number           |    1053422295
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    Entity Type          |    Organization 
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    Legal Business Name  |    HBR BOWLING GREEN, LLC 
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Dates
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    Enumeration Date     |    08/31/2006
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    Last Update Date     |    09/10/2019
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Provider Practice Location Address
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    Address Line         |    2365 NASHVILLE RD 
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    City                 |    BOWLING GREEN
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    State                |    KY
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    Zip                  |    42101-4144
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    Country              |    US
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    Telephone            |    270-842-1641
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    Fax                  |    270-782-9961
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Provider Business Mailing Address
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    Address Line         |    101 SUN AVE NE COMPLIANCE DEPARTMENT
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    City                 |    ALBUQUERQUE
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    State                |    NM
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    Zip                  |    87109-4373
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    Country              |    US
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    Telephone            |    505-468-5604
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    Fax                  |    505-468-4681
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Authorized Official
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    Title or Position    |    ASSISTANT SECRETARY
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    Name                 |     MICHAEL  BERG 
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    Credential           |    
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    Telephone            |    505-468-4742
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    314000000X
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    Taxonomy Name        |    Skilled Nursing Facility
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    License Number       |    
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    License Number State |    KY
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