MEDICARE: CHI LIVING COMMUNITIES

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	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1285095893
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHI LIVING COMMUNITIES

Provider Business Mailing Address
First Line	:	2345 AMSTERDAM RD
Second Line	:
City	:	VILLA HILLS
State	:	KY
Zip	:	41017-3711
Country	:	US
Telephone Number	:	859-426-6400
Fax Number	:

Provider Business Practice Location Address
First Line	:	2345 AMSTERDAM RD
Second Line	:
City	:	VILLA HILLS
State	:	KY
Zip	:	41017-3711
Country	:	US
Telephone Number	:	859-426-6400
Fax Number	:

Authorized Official
Title or Position	:	CHIEF OPERATIONS OFFICER
Name	:	WENDY DOLYK
Credential	:
Telephone Number	:	567-455-0414

Provider Enumeration Date	:	03/09/2016
Last Update Date	:	03/09/2016

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