Provider Demographics
NPI:1215031836
Name:GLENVIEW HEALTH CARE FACILITY, INC.
Entity Type:Organization
Organization Name:GLENVIEW HEALTH CARE FACILITY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KAY
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-651-8332
Mailing Address - Street 1:PO BOX 1507
Mailing Address - Street 2:
Mailing Address - City:GLASGOW
Mailing Address - State:KY
Mailing Address - Zip Code:42142-1507
Mailing Address - Country:US
Mailing Address - Phone:270-651-8332
Mailing Address - Fax:270-651-8069
Practice Address - Street 1:1002 GLENVIEW DR
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:KY
Practice Address - Zip Code:42141-3424
Practice Address - Country:US
Practice Address - Phone:270-651-8332
Practice Address - Fax:270-651-8069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY100012313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY12501409Medicaid
KY0858950001Medicare NSC
KY185271Medicare Oscar/Certification