# SNH DERBY TENANT LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SNH DERBY TENANT LLC
- **Other names:** Lexington Country Place
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1326698234
- **Legal business name:** SNH DERBY TENANT LLC
- **Authorized official:** JENNIFER F. MINTZER (PRESIDENT & CHIEF OPERATING OFFICER)
- **Authorized official phone:** (617) 796-8350

## Contact information

- **Practice address:** 700 MASON HEADLEY RD, LEXINGTON, KY 40504-2326
- **Practice address phone:** (859) 259-3486
- **Practice address fax:** (859) 276-2751
- **Mailing address:** 255 WASHINGTON ST STE 300, NEWTON, MA 02458-1634
- **Mailing address phone:** (617) 796-8350

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | — | NULL | — |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 09/13/2019
- **Last updated:** 05/04/2020

## Other identifiers

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