Provider Demographics
NPI:1568495059
Name:SANSBURY CARE CENTER, INC.
Entity Type:Organization
Organization Name:SANSBURY CARE CENTER, INC.
Other - Org Name:LITERARY SOCIETY OF ST. CATHARINE OF SIENA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:HERALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-336-3974
Mailing Address - Street 1:2625 BARDSTOWN ROAD
Mailing Address - Street 2:
Mailing Address - City:ST CATHARINE
Mailing Address - State:KY
Mailing Address - Zip Code:40061-9435
Mailing Address - Country:US
Mailing Address - Phone:859-336-3974
Mailing Address - Fax:859-336-9306
Practice Address - Street 1:2625 BARDSTOWN ROAD
Practice Address - Street 2:
Practice Address - City:ST CATHARINE
Practice Address - State:KY
Practice Address - Zip Code:40061-9435
Practice Address - Country:US
Practice Address - Phone:859-336-3974
Practice Address - Fax:859-336-9306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY100505314000000X
KY314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY12501888Medicaid
185297Medicare ID - Type Unspecified