# MASONIC HOMES OF KENTUCKY INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669495131
- **Authorized official:** MRS. DEBRA FINNERAN R.N. (ADMINISTRATOR)
- **Authorized official phone:** (502) 633-3486

## Contact information

- **Practice address:** 711 FRANKFORT RD, SHELBYVILLE, KY 40065-9447
- **Practice address phone:** (502) 633-3486
- **Practice address fax:** (502) 633-0661
- **Mailing address:** 711 FRANKFORT RD, P.O. BOX 909, SHELBYVILLE, KY 40065-9447
- **Mailing address phone:** (502) 633-3486
- **Mailing address fax:** (502) 633-0661

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 100386 | KY | Yes |

## Other

- **Enumeration date:** 07/25/2006
- **Last updated:** 12/22/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000054519 | ANTHEM PROVIDER NUMBER | KY |
| 05 | — | 12502571 | — | KY |
| 01 | — | 2438960000 | PASSPORT ADVANTAGE | KY |
| 01 | — | 5394544 | AETNA PROVIDER NUMBER | KY |