# MIDDLESBORO MANOR LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Middlesboro Health Care Facility
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881683480
- **Authorized official:** MRS. KIMBERLY MORROW (VP OF ADMINISTRATIVE SUPPORT)
- **Authorized official phone:** (859) 623-0898

## Contact information

- **Practice address:** 235 NEW WILSON LN, MIDDLESBORO, KY 40965-2705
- **Practice address phone:** (606) 248-0925
- **Practice address fax:** (606) 242-2544
- **Mailing address:** 300 PROVIDER CT, SUITE 100, RICHMOND, KY 40475-8488
- **Mailing address phone:** (859) 623-0898
- **Mailing address fax:** (859) 623-0843

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 100639 | KY | Yes |

## Other

- **Enumeration date:** 10/17/2005
- **Last updated:** 07/25/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 12504205 | — | KY |
| 05 | — | 7100244560 | — | KY |
| 05 | — | 90160763 | — | KY |