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General NPI Number Information
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NPI Number | 1205336054
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Entity Type | Organization
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Legal Business Name | PADUCAH CENTER FOR HEALTH AND REHABILITATION, LLC
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Dates
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Enumeration Date | 02/19/2018
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 4747 ALBEN BARKLEY DR
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City | PADUCAH
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State | KY
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Zip | 42001-6789
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Country | US
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Telephone | 270-444-9661
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Fax |
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Provider Business Mailing Address
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Address Line | 2100 CHEROKEE RIDGE WAY STE 100
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City | LOUISVILLE
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State | KY
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Zip | 40205-1600
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Country | US
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Telephone | 502-667-8150
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MICK VUJANOVIC
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Credential |
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Telephone | 502-667-8150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number |
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number |
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State | KY
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Taxonomy #4
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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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