# MT. LEBANON PERSONAL CARE HOME INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** DBA- James S Taylor Memorial Home
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083697452
- **Authorized official:** MS. REGINA LOUISE LYONS CMA, CFO (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (502) 589-0727

## Contact information

- **Practice address:** 1015 MAGAZINE STREET, LOUISVILLE, KY 40203
- **Practice address phone:** (502) 589-0727
- **Practice address fax:** (502) 589-3086
- **Mailing address:** 1015 MAGAZINE STREET, LOUISVILLE, KY 40203
- **Mailing address phone:** (502) 589-0727
- **Mailing address fax:** (502) 589-3086

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 100536 | KY | Yes |

## Other

- **Enumeration date:** 11/21/2005
- **Last updated:** 07/17/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 12502126 | — | KY |