Organization
COMMONWEALTH OF KENTUCKY
Active
Parent organization
COMMONWEALTH OF KENTUCKY
Other names
Eastern State Hospital Long Term Care/Acquired Brain Injury (LTC/ABI)
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMONWEALTH OF KENTUCKY
Authorized official
MS. WENDY T MORRIS (DEPUTY COMMISSIONER)
(502) 564-4860
Entity
Organization
Contact information
Practice address
1350 BULL LEA RD, LEXINGTON, KY 40511-1247
(859) 246-8000
(859) 246-8043
Mailing address
1350 BULL LEA RD, LEXINGTON, KY 40511-1247
(859) 246-8000
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
101245
KY
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100344920
—
KY
Enumeration date
01/24/2014
Last updated
11/03/2015
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