Provider Demographics
NPI:1396389748
Name:ST. MATTHEWS CARE AND REHAB CENTER, LLC
Entity Type:Organization
Organization Name:ST. MATTHEWS CARE AND REHAB CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AR BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-255-0075
Mailing Address - Street 1:1050 CHINOE RD STE 350
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-6571
Mailing Address - Country:US
Mailing Address - Phone:859-255-0075
Mailing Address - Fax:859-281-5150
Practice Address - Street 1:227 BROWNS LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-3215
Practice Address - Country:US
Practice Address - Phone:502-893-2595
Practice Address - Fax:502-526-5960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-29
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility