Organization
GARRARD CONVALESCENT HOME SNF
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RALPH L. STACEY JR. (PRESIDENT)
(859) 581-9393
Entity
Organization
Contact information
Practice address
425 GARRARD ST, COVINGTON, KY 41011-2562
(859) 581-9393
(859) 291-2006
Mailing address
425 GARRARD ST, COVINGTON, KY 41011-2562
(859) 581-9393
(859) 291-2006
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
100266
KY
314000000X
Skilled Nursing Facility
100266
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12500948
—
KY
05
—
1500955
—
KY
Enumeration date
01/06/2006
Last updated
09/11/2025
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