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General NPI Number Information
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NPI Number | 1609905272
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Entity Type | Organization
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Legal Business Name | HYDEN NURSING HOME, LLC
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 05/07/2008
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Provider Practice Location Address
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Address Line | 21040 US 421 SOUTH
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City | HYDEN
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State | KY
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Zip | 41749
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Country | US
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Telephone | 606-672-2940
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Fax | 606-672-4167
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Provider Business Mailing Address
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Address Line | PO BOX 618
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City | HYDEN
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State | KY
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Zip | 41749-0618
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Country | US
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Telephone | 606-672-2940
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Fax | 606-672-4167
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Authorized Official
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Title or Position | MEMBER
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Name | MR. TERRY EMANUEL FORCHT
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Credential |
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Telephone | 606-528-9600
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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 | 100624
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License Number State | KY
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