# COMMONWEALTH OF KENTUCKY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** COMMONWEALTH OF KENTUCKY
- **Other names:** Eastern State Hospital Long Term Care/Acquired Brain Injury (LTC/ABI)
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1356764559
- **Legal business name:** COMMONWEALTH OF KENTUCKY
- **Authorized official:** MS. WENDY T MORRIS (DEPUTY COMMISSIONER)
- **Authorized official phone:** (502) 564-4860

## Contact information

- **Practice address:** 1350 BULL LEA RD, LEXINGTON, KY 40511-1247
- **Practice address phone:** (859) 246-8000
- **Practice address fax:** (859) 246-8043
- **Mailing address:** 1350 BULL LEA RD, LEXINGTON, KY 40511-1247
- **Mailing address phone:** (859) 246-8000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 101245 | KY | — |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 01/24/2014
- **Last updated:** 11/03/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7100344920 | — | KY |