# AHF KENTUCKY-IOWA, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** GEORGETOWN MANOR NURSING & REHAB
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962486910
- **Authorized official:** MR. MARK T HAEMMERLE CPA, INACTIVE (PRESIDENT)
- **Authorized official phone:** (614) 760-7352

## Contact information

- **Practice address:** 900 GAGEL AVE, LOUISVILLE, KY 40216-4012
- **Practice address phone:** (502) 368-5827
- **Practice address fax:** (502) 361-0515
- **Mailing address:** 4248 TULLER RD, DUBLIN, OH 43017-5025
- **Mailing address phone:** (614) 760-7352
- **Mailing address fax:** (614) 760-7356

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 100208 | KY | Yes |

## Other

- **Enumeration date:** 12/02/2005
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 12501169 | — | KY |