Provider Demographics
NPI:1033108824
Name:NEW HART COUNTY HEALTH CARE CENTER, LLC
Entity Type:Organization
Organization Name:NEW HART COUNTY HEALTH CARE CENTER, LLC
Other - Org Name:HART COUNTY HEALTH & REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:REID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-786-2200
Mailing Address - Street 1:1505 S DIXIE ST
Mailing Address - Street 2:
Mailing Address - City:HORSE CAVE
Mailing Address - State:KY
Mailing Address - Zip Code:42749-1480
Mailing Address - Country:US
Mailing Address - Phone:270-786-2200
Mailing Address - Fax:270-786-6102
Practice Address - Street 1:1505 S DIXIE ST
Practice Address - Street 2:
Practice Address - City:HORSE CAVE
Practice Address - State:KY
Practice Address - Zip Code:42749-1480
Practice Address - Country:US
Practice Address - Phone:270-786-2200
Practice Address - Fax:270-786-6102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-14
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY100662314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY18-5381Medicare ID - Type Unspecified