# HURSTBOURNE HEALTHCARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Hurstbourne Care Centre at Stony Brook
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851338784
- **Authorized official:** ROY T. BABER (MANAGER)
- **Authorized official phone:** (502) 495-6240

## Contact information

- **Practice address:** 2200 STONY BROOK DR, LOUISVILLE, KY 40220-4016
- **Practice address phone:** (502) 495-6240
- **Practice address fax:** (502) 495-0324
- **Mailing address:** 2200 STONY BROOK DR, LOUISVILLE, KY 40220-4016
- **Mailing address phone:** (502) 495-6240
- **Mailing address fax:** (502) 495-0324

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 100645 NF | KY | Yes |
| 314000000X | Skilled Nursing Facility | 100645 PCH | KY | — |

## Other

- **Enumeration date:** 05/31/2006
- **Last updated:** 01/22/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 12504692 | — | KY |