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Organization
GAINESVILLE MANOR
Active
Organization
GAINESVILLE MANOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IDA WOODARD (ADMINISTRATOR)
(270) 886-0258
Entity
Organization
Contact information
Practice address
550 MOORES DR, HOPKINSVILLE, KY 42240
(270) 886-0258
Mailing address
550 MOORES DR, HOPKINSVILLE, KY 42240
(270) 886-0258
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
100066
KY
Other
Enumeration date
03/18/2008
Last updated
03/18/2008
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