# PAVILION AT KENTON FOR NURSING AND REHABILITATION LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942723085
- **Authorized official:** RAFAEL A MOERMAN (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (848) 299-3662

## Contact information

- **Practice address:** 401 E 20TH ST, COVINGTON, KY 41014-1583
- **Practice address phone:** (859) 283-6600
- **Mailing address:** 156 BEACH 9TH ST APT 9F, FAR ROCKAWAY, NY 11691-5636

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 07/20/2017
- **Last updated:** 03/06/2018