Organization
DIVERSICARE LEASING CORP.
Active
Other names
Wurtland Nursing & Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND L. TYLER JR. (EXECUTIVE VICE PRESIDENT AND COO)
(615) 771-7575
Entity
Organization
Contact information
Practice address
100 WURTLAND AVE, GREENUP, KY 41144-1445
(606) 836-0931
(606) 833-5605
Mailing address
100 WURTLAND AVE, GREENUP, KY 41144-1445
(606) 836-0931
(606) 833-5605
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
100449
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12503009
—
KY
Enumeration date
10/11/2005
Last updated
08/22/2020
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