MEDICARE: ROBERT E LEE INVESTORS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility		IN

General Provider Information

NPI Number	:	1073715801
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT E LEE INVESTORS, LLC

Provider Business Mailing Address
First Line	:	201 E ELM ST
Second Line	:
City	:	NEW ALBANY
State	:	IN
Zip	:	47150-3428
Country	:	US
Telephone Number	:	812-945-9517
Fax Number	:	812-981-3303

Provider Business Practice Location Address
First Line	:	201 E ELM ST
Second Line	:
City	:	NEW ALBANY
State	:	IN
Zip	:	47150-3428
Country	:	US
Telephone Number	:	812-945-9517
Fax Number	:	812-981-3303

Authorized Official
Title or Position	:	TRUSTEE
Name	:	ELLIOTT D LEVIN
Credential	:
Telephone Number	:	812-945-9517

Provider Enumeration Date	:	06/04/2007
Last Update Date	:	08/22/2020

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