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Organization
MID-SOUTH NURSING HOMES, INC
Active
Organization
MID-SOUTH NURSING HOMES, INC
Active
Other names
Pinecrest Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD M WEHTJE (VP CFO)
(407) 975-3010
Entity
Organization
Contact information
Practice address
950 HIGHPOINT DR, HOPKINSVILLE, KY 42240-2570
(270) 885-1151
(270) 885-7461
Mailing address
602 COURTLAND ST, SUITE 200, ORLANDO, FL 32804-1360
(407) 975-3000
(407) 975-3090
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
100070
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12500153
—
KY
05
—
90003997
—
KY
Enumeration date
04/26/2007
Last updated
08/22/2020
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