Provider Demographics
NPI:1558674044
Name:ATRIA SENIOR LIVING GROUP, INC
Entity Type:Organization
Organization Name:ATRIA SENIOR LIVING GROUP, INC
Other - Org Name:ATRIA ST. MATTEWS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL COUNSEL & SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-779-7677
Mailing Address - Street 1:120 S HUBBARDS LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-3993
Mailing Address - Country:US
Mailing Address - Phone:502-896-1759
Mailing Address - Fax:
Practice Address - Street 1:120 S HUBBARDS LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-3993
Practice Address - Country:US
Practice Address - Phone:502-896-1759
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-26
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY20010605602310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility