Organization
CALVERT CITY CONVALESCENT CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURIE M TRAVIS (ASST BUSINESS ADMN)
(270) 395-4124
Entity
Organization
Contact information
Practice address
1201 5TH AVE, CALVERT CITY, KY 42029-8233
(270) 395-4124
(270) 395-4962
Mailing address
1201 5TH AVE, PO BOX 7, CALVERT CITY, KY 42029-8233
(270) 395-4124
(270) 395-4962
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12500443
—
KY
Enumeration date
09/23/2005
Last updated
08/22/2020
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