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General NPI Number Information
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NPI Number | 1457926800
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Entity Type | Organization
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Legal Business Name | WILLIAMSTOWN KY OPCO LLC
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Dates
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Enumeration Date | 05/26/2021
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 201 KIMBERLY LN
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City | WILLIAMSTOWN
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State | KY
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Zip | 41097-9458
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Country | US
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Telephone | 859-824-7803
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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 | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #2
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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 |
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