Provider Demographics
NPI:1831319987
Name:SPARKS NURSING CENTER, INC.
Entity Type:Organization
Organization Name:SPARKS NURSING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORP SECRETARY TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:MURIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCROY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-338-1541
Mailing Address - Street 1:500 EAST WHITMER STREET
Mailing Address - Street 2:
Mailing Address - City:CENTRAL CITY
Mailing Address - State:KY
Mailing Address - Zip Code:42330
Mailing Address - Country:US
Mailing Address - Phone:270-338-1541
Mailing Address - Fax:270-338-4367
Practice Address - Street 1:500 E WHITMER ST
Practice Address - Street 2:
Practice Address - City:CENTRAL CITY
Practice Address - State:KY
Practice Address - Zip Code:42330-1197
Practice Address - Country:US
Practice Address - Phone:270-338-1541
Practice Address - Fax:270-338-4367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY100346311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home