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Organization
DIVERSICARE OF GREENVILLE, LLC
Active
Organization
DIVERSICARE OF GREENVILLE, LLC
Active
Parent organization
DIVERSICARE LEASING COMPANY II, LLC
Other names
Diversicare of Greenville
Organization subpart
Yes
Provider details
NPI number
Legal business name
DIVERSICARE LEASING COMPANY II, LLC
Authorized official
KELLY J GILL (PRESIDENT AND CEO)
(615) 771-7575
Entity
Organization
Contact information
Practice address
521 GREENE DR, GREENVILLE, KY 42345-1409
(270) 338-1523
(615) 620-7875
Mailing address
521 GREENE DR, GREENVILLE, KY 42345-1409
(270) 338-1523
(615) 620-7875
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100364170
—
KY
Enumeration date
08/22/2014
Last updated
10/21/2015
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