Provider Demographics
NPI:1043205065
Name:HOMESTEAD NURSING & REHAB CENTER
Entity Type:Organization
Organization Name:HOMESTEAD NURSING & REHAB CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN-ADMISSION COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:N/A
Authorized Official - Last Name:COOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPN-AC
Authorized Official - Phone:859-252-0871
Mailing Address - Street 1:1608 VERSAILLES RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2402
Mailing Address - Country:US
Mailing Address - Phone:859-252-0871
Mailing Address - Fax:859-389-9571
Practice Address - Street 1:1608 VERSAILLES RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-2402
Practice Address - Country:US
Practice Address - Phone:859-252-0871
Practice Address - Fax:859-389-9571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3140N1450X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric