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General NPI Number Information
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NPI Number | 1558627281
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Entity Type | Organization
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Legal Business Name | PAINTSVILLE INVESTORS, LLC
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Dates
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Enumeration Date | 04/06/2012
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Last Update Date | 03/02/2015
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Provider Practice Location Address
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Address Line | 1025 EUCLID AVE
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City | PAINTSVILLE
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State | KY
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Zip | 41240-8645
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Country | US
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Telephone | 606-789-5808
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Fax | 606-789-1813
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Provider Business Mailing Address
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Address Line | 1025 EUCLID AVE
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City | PAINTSVILLE
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State | KY
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Zip | 41240-8645
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Country | US
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Telephone | 606-789-5808
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Fax | 606-789-1813
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. EMILY REGENEA JONES-GRAY
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Credential | MSW
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Telephone | 606-789-5808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number | 101129
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License Number State | KY
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