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Organization

MT. LEBANON PERSONAL CARE HOME INC.

Active
Other names
DBA- James S Taylor Memorial Home
Organization subpart
No

Provider details

NPI number
Authorized official
MS. REGINA LOUISE LYONS CMA, CFO (CHIEF FINANCIAL OFFICER)
(502) 589-0727
Entity
Organization

Contact information

Practice address
1015 MAGAZINE STREET, LOUISVILLE, KY 40203
(502) 589-0727
(502) 589-3086
Mailing address
1015 MAGAZINE STREET, LOUISVILLE, KY 40203
(502) 589-0727
(502) 589-3086

Taxonomy

Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
100536
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
12502126
KY
Enumeration date
11/21/2005
Last updated
07/17/2008
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