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General NPI Number Information
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NPI Number | 1164703955
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Entity Type | Organization
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Legal Business Name | CHRISTIAN HEALTH CENTER - WEST, INC.
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Dates
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Enumeration Date | 09/07/2011
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Last Update Date | 05/19/2014
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Provider Practice Location Address
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Address Line | 1015 MAGAZINE ST
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City | LOUISVILLE
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State | KY
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Zip | 40203-2017
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Country | US
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Telephone | 502-254-4201
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Fax | 502-254-4209
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Provider Business Mailing Address
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Address Line | 1015 MAGAZINE ST
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City | LOUISVILLE
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State | KY
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Zip | 40203-2017
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Country | US
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Telephone | 502-254-4201
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Fax | 502-254-4209
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | DR. KEITH R. KNAPP
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Credential | PHD
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Telephone | 502-254-4200
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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 | 100536
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License Number State | KY
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