# EXTENDICARE HOMES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Medco Center of Paducah
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619041340
- **Authorized official:** DONNA JO MAASSEN (DIRECTOR OF COMPLIANCE)
- **Authorized official phone:** (414) 908-8119

## Contact information

- **Practice address:** 867 MCGUIRE AVE, PADUCAH, KY 42001-4036
- **Practice address phone:** (270) 442-6168
- **Practice address fax:** (270) 443-6211
- **Mailing address:** 111 W MICHIGAN ST, MILWAUKEE, WI 53203-2903
- **Mailing address phone:** (414) 908-8119
- **Mailing address fax:** (414) 908-7105

## Taxonomy

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

## Other

- **Enumeration date:** 11/17/2006
- **Last updated:** 04/01/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 12501490 | — | KY |