Provider Demographics
NPI:1841289618
Name:NEW SUMMERFIELD HEALTH & REHABILITATION CENTER, LLC
Entity type:Organization
Organization Name:NEW SUMMERFIELD HEALTH & REHABILITATION CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FOOTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-448-8622
Mailing Address - Street 1:1877 FARNSLEY RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40216-4701
Mailing Address - Country:US
Mailing Address - Phone:502-448-8622
Mailing Address - Fax:502-448-4274
Practice Address - Street 1:1877 FARNSLEY RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40216-4701
Practice Address - Country:US
Practice Address - Phone:502-448-8622
Practice Address - Fax:502-448-4274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-14
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY100517314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY18-5300Medicare ID - Type Unspecified