# BEAVER DAM HEALTH CARE MANOR INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Beaver Dam Health Care Manor
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538321781
- **Authorized official:** MR. DAVID RODMAN (ASST SECRETARY)
- **Authorized official phone:** (407) 975-3011

## Contact information

- **Practice address:** 1595 US HIGHWAY 231 S, BEAVER DAM, KY 42320-9463
- **Practice address phone:** (270) 274-9646
- **Practice address fax:** (270) 274-9646
- **Mailing address:** 602 COURTLAND ST STE 200, ORLANDO, FL 32804-1340
- **Mailing address phone:** (407) 975-3000
- **Mailing address fax:** (407) 975-3090

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 100353 | KY | Yes |

## Other

- **Enumeration date:** 06/30/2008
- **Last updated:** 06/30/2008