Provider Demographics
NPI:1417071663
Name:CARDINAL HILL REHABILITATION HOSPITAL
Entity Type:Organization
Organization Name:CARDINAL HILL REHABILITATION HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, LD
Authorized Official - Phone:859-254-5701
Mailing Address - Street 1:697 KENOVA TRACE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40511
Mailing Address - Country:US
Mailing Address - Phone:859-420-1185
Mailing Address - Fax:
Practice Address - Street 1:2050 VERSAILLES ROAD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40511
Practice Address - Country:US
Practice Address - Phone:859-254-5701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-1168283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital