# MID-SOUTH NURSING HOMES, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pinecrest Manor
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861612681
- **Authorized official:** MR. RONALD M WEHTJE (VP CFO)
- **Authorized official phone:** (407) 975-3010

## Contact information

- **Practice address:** 950 HIGHPOINT DR, HOPKINSVILLE, KY 42240-2570
- **Practice address phone:** (270) 885-1151
- **Practice address fax:** (270) 885-7461
- **Mailing address:** 602 COURTLAND ST, SUITE 200, ORLANDO, FL 32804-1360
- **Mailing address phone:** (407) 975-3000
- **Mailing address fax:** (407) 975-3090

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 100070 | KY | Yes |

## Other

- **Enumeration date:** 04/26/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 12500153 | — | KY |
| 05 | — | 90003997 | — | KY |