Organization
NEW JACKSON MANOR, LLC
Active
Other names
Jackson Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILIP GILKISON (ADMINISTRATOR)
(606) 364-5197
Entity
Organization
Contact information
Practice address
121 STATE ROAD 3444, ANNVILLE, KY 40402-8701
(606) 364-5197
(606) 364-2293
Mailing address
PO BOX 194, ANNVILLE, KY 40402-0194
(606) 364-5197
(606) 364-2293
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
100602
KY
Other
Enumeration date
10/14/2005
Last updated
03/24/2014
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