Organization
PRESBYTERIAN HOMES AND SERVICES OF KENTUCKY, INC
Active
Other names
Good Shepherd Health, Good Shepherd Community Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
HATTIE WAGNER (CEO/PRESIDENT)
(502) 259-9101
Entity
Organization
Contact information
Practice address
60 PHILLIPS BRANCH RD, PHELPS, KY 41553-9061
(502) 259-9101
(502) 259-9109
Mailing address
PO BOX 18067, LOUISVILLE, KY 40261-0067
(502) 259-9101
(502) 259-9109
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
100516
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12504080
—
KY
Enumeration date
09/29/2005
Last updated
06/16/2018
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