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General NPI Number Information
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NPI Number | 1164422945
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Entity Type | Organization
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Legal Business Name | BUTLER REST HOME, INC
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Dates
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Enumeration Date | 07/22/2005
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Last Update Date | 08/27/2010
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Provider Practice Location Address
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Address Line | 305 TAYLOR LN
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City | BUTLER
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State | KY
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Zip | 41006-8550
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Country | US
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Telephone | 859-472-2217
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Fax | 859-472-5869
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Provider Business Mailing Address
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Address Line | PO BOX 402
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City | BUTLER
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State | KY
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Zip | 41006-0402
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Country | US
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Telephone | 859-472-2217
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Fax | 859-472-5869
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. KENNETH URLAGE
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Credential | B.S. BUSINESS ADMINI
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Telephone | 859-472-2217
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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 | 100362
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License Number State | KY
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