Organization
HQM OF LEXINGTON, LLC
Active
Other names
Mayfair Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL WALCZAK (CEO)
(561) 627-0664
Entity
Organization
Contact information
Practice address
3300 TATES CREEK RD, FAYETTE COUNTY, LEXINGTON, KY 40502-3408
(859) 266-2126
Mailing address
3300 TATES CREEK RD, FAYETTE COUNTY, LEXINGTON, KY 40502-3408
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12504353
—
KY
Enumeration date
07/08/2006
Last updated
08/22/2020
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