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General NPI Number Information
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NPI Number | 1326146200
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Entity Type | Organization
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Legal Business Name | MARLIN K. SPARKS MANAGEMENT COMPANY INC
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 05/07/2015
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Provider Practice Location Address
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Address Line | 203 BRUCE CT
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City | DANVILLE
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State | KY
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Zip | 40422-1948
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Country | US
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Telephone | 859-236-9292
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Fax | 859-236-3713
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Provider Business Mailing Address
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Address Line | 203 BRUCE CT
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City | DANVILLE
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State | KY
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Zip | 40422-1948
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Country | US
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Telephone | 859-236-9292
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Fax | 859-236-3713
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Authorized Official
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Title or Position | CO-OWNER
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Name | MRS. JILL SPARKS BROWN
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Credential |
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Telephone | 859-236-9292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 100037
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License Number State | KY
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