Organization
JACKSON MANOR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ROBIN BARBER (EXECUTIVE VICE PRESIDENT)
(502) 714-7444
Entity
Organization
Contact information
Practice address
96 HIGHWAY 3444, ANNVILLE, KY 40402-8245
(502) 714-7444
Mailing address
700 N HURSTBOURNE PKWY, LOUISVILLE, KY 40222-5393
(502) 714-7444
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12504965
—
KY
Enumeration date
04/15/2016
Last updated
04/15/2016
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