Provider Demographics
NPI:1689455297
Name:CHARTER SENIOR LIVING OF PADUCAH
Entity Type:Organization
Organization Name:CHARTER SENIOR LIVING OF PADUCAH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-868-0335
Mailing Address - Street 1:2201 NEW HOLT RD
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-7553
Mailing Address - Country:US
Mailing Address - Phone:270-297-4301
Mailing Address - Fax:
Practice Address - Street 1:2201 NEW HOLT RD
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-7553
Practice Address - Country:US
Practice Address - Phone:270-297-4301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility