# BEAVER DAM NURSING & REHAB CENTER, INC

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

## Provider details

- **NPI number:** 1669543716
- **Authorized official:** DOUGLAS P COX (PRESIDENT)
- **Authorized official phone:** (615) 478-6181

## Contact information

- **Practice address:** 1595 US HIGHWAY 231 S, BEAVER DAM, KY 42320-9463
- **Practice address phone:** (270) 274-9646
- **Mailing address:** 1595 US HIGHWAY 231 S, BEAVER DAM, KY 42320-9463
- **Mailing address phone:** (270) 274-9646

## Taxonomy

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

## Other

- **Enumeration date:** 11/12/2006
- **Last updated:** 08/18/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 12503595 | — | KY |
| 05 | — | 7100125280 | — | KY |