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General NPI Number Information
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NPI Number | 1912198284
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Entity Type | Organization
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Legal Business Name | LP CHIPLEY LLC
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Dates
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Enumeration Date | 08/05/2007
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Last Update Date | 05/12/2013
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Provider Practice Location Address
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Address Line | 879 USERY RD
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City | CHIPLEY
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State | FL
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Zip | 32428-9303
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Country | US
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Telephone | 850-638-4654
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Fax | 850-638-0918
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Provider Business Mailing Address
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Address Line | 12201 BLUEGRASS PKWY
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City | LOUISVILLE
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State | KY
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Zip | 40299-2361
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Country | US
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Telephone | 502-568-7800
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Fax | 502-568-7150
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Authorized Official
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Title or Position | CFO
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Name | MR. JOHN HARRISON
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Credential |
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Telephone | 502-568-7800
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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 | SNF1065096
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License Number State | FL
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