Mt. Lebanon Personal Care Home Inc.

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

100536 Issued in KY

Legal business name

MT. LEBANON PERSONAL CARE HOME INC.

Doing business as

DBA- James S Taylor Memorial Home

Practice address

1015 Magazine Street
Louisville, KY 40203

Phone

(502) 589-0727

Fax

(502) 589-3086

NPI assigned

Nov 21, 2005

Organization subpart

No

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

Authorized official

Name

Ms. Regina Louise Lyons, CMA, CFO

Title

Chief Financial Officer

Phone

(502) 589-0727

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• DBA- James S Taylor Memorial Home Doing business as

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216252800000",
    "number": "1083697452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 MAGAZINE STREET",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40203",
            "telephone_number": "502-589-0727",
            "fax_number": "502-589-3086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 MAGAZINE STREET",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40203",
            "telephone_number": "502-589-0727",
            "fax_number": "502-589-3086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT. LEBANON PERSONAL CARE HOME INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-21",
        "last_updated": "2008-07-17",
        "status": "A",
        "authorized_official_last_name": "LYONS",
        "authorized_official_first_name": "REGINA",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "502-589-0727",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CMA, CFO"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "KY",
            "license": "100536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12502126",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA- James S Taylor Memorial Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Nursing Facility/Intermediate Care Facility in Louisville, KY
• Providers in Louisville, KY by specialty
• Nursing Facility/Intermediate Care Facility in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2008; 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.