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General NPI Number Information
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NPI Number | 1609987742
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Entity Type | Organization
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Legal Business Name | HBR OWENSBORO, LLC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 10/01/2009
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Provider Practice Location Address
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Address Line | 3362 BUCKLAND SQ
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City | OWENSBORO
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State | KY
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Zip | 42301-5829
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Country | US
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Telephone | 270-689-0930
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Fax | 270-689-9348
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Provider Business Mailing Address
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Address Line | 101 SUN AVE NE COMPLIANCE DEPARTMENT
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-4373
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Country | US
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Telephone | 505-468-5604
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Fax | 505-468-4681
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Authorized Official
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Title or Position | PRESIDENT DIRECTOR
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Name | WILLIAM A MATHIES
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Credential |
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Telephone | 505-821-3355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State | KY
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