Organization
LIFELINE HEALTH CARE OF KENTUCKY #3, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES T. WILSON (CEO)
(606) 679-4100
Entity
Organization
Contact information
Practice address
60 SHELTON LN, RUSSELLVILLE, KY 42276-7203
(270) 726-2408
(270) 726-7213
Mailing address
600 CLIFTY ST, SOMERSET, KY 42503-1733
(606) 679-4100
(606) 678-7306
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34004713
—
KY
05
—
42007112
—
KY
05
—
45342565
—
KY
Enumeration date
07/09/2006
Last updated
09/11/2025
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