Organization
NICHOLASVILLE NURSING AND REHABILITATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL PRUITT (OFFICER)
(317) 288-4029
Entity
Organization
Contact information
Practice address
100 SPARKS AVE, NICHOLASVILLE, KY 40356-1004
(859) 885-4171
Mailing address
100 BOULEVARD OF AMERICAS, LAKEWOOD, NJ 08701-4585
(732) 961-8400
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
08/06/2019
Last updated
07/20/2023
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