Organization
LARUE COUNTY GERIATRIC CENTER, INC.
Active
Other names
Sunrise Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DAPHNE S. LOYALL (ADMINISTRATOR)
(270) 358-3103
Entity
Organization
Contact information
Practice address
80 PHILLIPS LN, HODGENVILLE, KY 42748-1645
(270) 358-3103
(270) 358-8412
Mailing address
80 PHILLIPS LN, HODGENVILLE, KY 42748-1645
(270) 358-3103
(270) 358-8412
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
750086
KY
314000000X
Skilled Nursing Facility
Primary
100277
KY
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
100277
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100277
—
KY
05
—
12502233
—
KY
05
—
43010628
—
KY
Enumeration date
06/01/2005
Last updated
05/26/2010
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