Organization
LIVINGSTON HOSPITAL AND HEALTHCARE SERVICES, INC.
Active
Other names
Grand Lakes Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK A EDWARDS (ADMINISTRATOR//CEO)
(270) 988-7235
Entity
Organization
Contact information
Practice address
1860 J.H. O'BRYAN AVE., GRAND RIVERS, KY 42045
(270) 362-8246
(270) 362-9757
Mailing address
131 HOSPITAL DR, SALEM, KY 42078-8043
(270) 988-7296
(270) 988-3900
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
900135
KY
Other
Enumeration date
02/25/2009
Last updated
08/05/2011
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