Organization
DIVERSICARE HIGHLANDS, LLC
Active
Parent organization
DIVERSICARE HEALTHCARE SERVICES, INC.
Other names
Highlands Health and Rehabilitation Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
DIVERSICARE HEALTHCARE SERVICES, INC.
Authorized official
KELLY J GILL (PRESIDENT AND CEO)
(615) 771-7575
Entity
Organization
Contact information
Practice address
1705 STEVENS AVE, LOUISVILLE, KY 40205-1044
(502) 451-9330
(615) 620-7875
Mailing address
1705 STEVENS AVE, LOUISVILLE, KY 40205-1044
(502) 451-9330
(615) 620-7875
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100229500
—
KY
Enumeration date
08/14/2012
Last updated
06/01/2015
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