# LARUE COUNTY GERIATRIC CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sunrise Manor
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003818303
- **Authorized official:** MRS. DAPHNE S. LOYALL (ADMINISTRATOR)
- **Authorized official phone:** (270) 358-3103

## Contact information

- **Practice address:** 80 PHILLIPS LN, HODGENVILLE, KY 42748-1645
- **Practice address phone:** (270) 358-3103
- **Practice address fax:** (270) 358-8412
- **Mailing address:** 80 PHILLIPS LN, HODGENVILLE, KY 42748-1645
- **Mailing address phone:** (270) 358-3103
- **Mailing address fax:** (270) 358-8412

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA0600X | Adult Day Care Clinic/Center | 750086 | KY | — |
| 314000000X | Skilled Nursing Facility | 100277 | KY | Yes |
| 332BP3500X | Parenteral & Enteral Nutrition Supplies (DME) | 100277 | KY | — |

## Other

- **Enumeration date:** 06/01/2005
- **Last updated:** 05/26/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100277 | — | KY |
| 05 | — | 12502233 | — | KY |
| 05 | — | 43010628 | — | KY |