Organization
DIVERSICARE OF BRADFORD PLACE, LLC
Active
Other names
Diversicare of Bradford Place
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES R. MCKNIGHT JR. (CEO)
(615) 771-7575
Entity
Organization
Contact information
Practice address
1302 MILLVILLE AVE, HAMILTON, OH 45013-3961
(513) 867-4100
(513) 867-1415
Mailing address
1302 MILLVILLE AVE, HAMILTON, OH 45013-3961
(513) 867-4100
(513) 867-1415
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0096324
—
OH
Enumeration date
05/27/2021
Last updated
05/27/2021
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