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General NPI Number Information
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NPI Number | 1497243455
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Entity Type | Organization
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Legal Business Name | LANDMARK OF ELKHORN CITY REHABILITATION AND NURSING CENTER
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Dates
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Enumeration Date | 04/25/2018
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Last Update Date | 10/03/2018
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Provider Practice Location Address
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Address Line | 945 W RUSSELL ST
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City | ELKHORN CITY
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State | KY
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Zip | 41522-9032
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Country | US
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Telephone | 606-754-4134
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Fax |
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Provider Business Mailing Address
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Address Line | 6101 NIMTZ PKWY
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City | SOUTH BEND
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State | IN
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Zip | 46628-6111
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Country | US
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Telephone | 269-281-4200
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | JOSEPH MEISELS
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Credential |
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Telephone | 269-281-4200
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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 |
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License Number State |
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