Organization
CHRISTIAN CARE COMMUNITIES, INC.
Active
Other names
Christian Health Center Louisville
Organization subpart
No
Provider details
NPI number
Authorized official
MR. W. RICHARD MARSHALL (VICE PRESIDENT CFO)
(502) 254-4200
Entity
Organization
Contact information
Practice address
920 S 4TH ST, LOUISVILLE, KY 40203-3206
(502) 254-4200
Mailing address
12710 TOWNEPARK WAY, SUITE 1000, LOUISVILLE, KY 40243-2534
(502) 254-4200
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
100200
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000054506
ANTHEM BLUE CROSS
KY
05
—
12504528
—
KY
01
—
2435838000
PASSPORT
KY
Enumeration date
01/30/2007
Last updated
05/12/2014
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