Provider Demographics
NPI:1720756380
Name:LEXINGTON PREMIER NURSING & REHAB LLC
Entity Type:Organization
Organization Name:LEXINGTON PREMIER NURSING & REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED SIGNATORY
Authorized Official - Prefix:
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:WALDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-415-4005
Mailing Address - Street 1:2770 PALUMBO DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-1232
Mailing Address - Country:US
Mailing Address - Phone:859-263-2410
Mailing Address - Fax:859-263-2930
Practice Address - Street 1:2770 PALUMBO DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1232
Practice Address - Country:US
Practice Address - Phone:859-263-2410
Practice Address - Fax:859-263-2930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility