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General NPI Number Information
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NPI Number | 1871577981
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Entity Type | Organization
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Legal Business Name | ST ELIZABETH MEDICAL CENTER SKILLED FACILITY
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Dates
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Enumeration Date | 12/01/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 401 E 20TH ST
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City | COVINGTON
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State | KY
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Zip | 41014-1583
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Country | US
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Telephone | 859-292-4145
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Fax | 859-292-4828
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Provider Business Mailing Address
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Address Line | 401 E 20TH ST
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City | COVINGTON
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State | KY
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Zip | 41014-1583
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Country | US
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Telephone | 859-292-4145
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Fax | 859-292-4828
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MAUREEN A HEBERT
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Credential | MS, NHA
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Telephone | 859-292-4344
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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 | 185345
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License Number State | KY
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