Grant Manor, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

100694 Issued in KY

Legal business name

GRANT MANOR, LLC

Doing business as

Grant Manor Care and Rehabilitation Center

Practice address

201 Kimberly LN
Williamstown, KY 41097-9458

Phone

(859) 824-7803

Fax

(859) 824-9604

NPI assigned

Aug 17, 2006

Last updated

Sep 30, 2009By the provider in NPPES

Organization subpart

Yes

Parent organization

SUNBRIDGE HEALTHCARE CORPORATIONAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

William A Mathies

Title

President Director

Phone

(505) 821-3355

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Grant Manor Care and Rehabilitation Center Doing business as

Part of

Sunrise HLTH Care Corp

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Sunbridge Healthcare LLC

  dba Merry Wood Lodge

  • Skilled Nursing Facility
  • Elmore, AL
  • NPI 1104876226

  Member Of

  NPD member

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254268800000",
    "number": "1053424549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SUN AVE NE",
            "address_2": "COMPLIANCE DEPARTMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094373",
            "telephone_number": "505-468-5604",
            "fax_number": "505-468-4681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 KIMBERLY LN",
            "city": "WILLIAMSTOWN",
            "state": "KY",
            "postal_code": "410979458",
            "telephone_number": "859-824-7803",
            "fax_number": "859-824-9604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANT MANOR, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUNBRIDGE HEALTHCARE CORPORATION",
        "enumeration_date": "2006-08-17",
        "last_updated": "2009-09-30",
        "status": "A",
        "authorized_official_last_name": "MATHIES",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT DIRECTOR",
        "authorized_official_telephone_number": "505-821-3355"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "KY",
            "license": "100694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12504858",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grant Manor Care and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stella Egan
• Sandra Elliott
• Carol Fairchild, PTA, ATC
• Foot Specialists of Greater Cincinnati
• Grant County Board of Education
• Leigh Ann Grant, ANN,RNC
• Kristine Marie Gulley, PTA
• Amy Gutman, PT
• Emily Hagedorn, COTA/L
• Mary Diane Hamm, LCSW

• Skilled Nursing Facility in Williamstown, KY
• Providers in Williamstown, KY by specialty
• Skilled Nursing Facility in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.