Organization
DIVERSICARE OF BRADFORD PLACE, LLC
Active
Parent organization
DIVERSICARE LEASING COMPANY II, LLC
Other names
Diversicare of Bradford Place
Organization subpart
Yes
Provider details
NPI number
Legal business name
DIVERSICARE LEASING COMPANY II, LLC
Authorized official
JAMES R. MCKNIGHT JR. (PRESIDENT & CEO)
(615) 771-7575
Entity
Organization
Contact information
Practice address
1302 MILLVILLE AVE, HAMILTON, OH 45013-3961
(513) 867-4100
(513) 867-1415
Mailing address
1302 MILLVILLE AVE, HAMILTON, OH 45013-3961
(513) 867-4100
(513) 867-1415
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0096324
—
OH
Enumeration date
09/11/2013
Last updated
05/28/2021
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