Provider Demographics
NPI:1619218385
Name:LP CALVERT CITY, LLC
Entity Type:Organization
Organization Name:LP CALVERT CITY, LLC
Other - Org Name:OAKVIEW NURSING & REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-568-7800
Mailing Address - Street 1:10456 US HIGHWAY 62
Mailing Address - Street 2:
Mailing Address - City:CALVERT CITY
Mailing Address - State:KY
Mailing Address - Zip Code:42029-9020
Mailing Address - Country:US
Mailing Address - Phone:270-898-6288
Mailing Address - Fax:
Practice Address - Street 1:10456 US HIGHWAY 62
Practice Address - Street 2:
Practice Address - City:CALVERT CITY
Practice Address - State:KY
Practice Address - Zip Code:42029-9020
Practice Address - Country:US
Practice Address - Phone:270-898-6288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-06
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYAPPLIED FOR314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
185195Medicare Oscar/Certification