HBR Campbell Lane, LLC

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

Legal business name

HBR CAMPBELL LANE, LLC

Practice address

1381 Campbell LN
Bowling Green, KY 42104-1049

Phone

(270) 843-0587

Fax

(270) 843-0874

NPI assigned

Aug 31, 2006

Organization subpart

Yes

Parent organization

HBR KENTUCKY LLCAs reported in NPPES

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

Authorized official

Name

Michael T Berg

Title

Assistant Secretary

Phone

(505) 821-3355

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Magnolia Village Doing business as

Member of 1

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

• Sunbridge Healthcare LLC

  • Skilled Nursing Facility
  • Tuscumbia, AL
  • NPI 1285685362

  Member Of

  NPD member

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472083200000",
    "number": "1144331216",
    "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": "1381 CAMPBELL LN",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421041049",
            "telephone_number": "270-843-0587",
            "fax_number": "270-843-0874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HBR CAMPBELL LANE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HBR KENTUCKY LLC",
        "enumeration_date": "2006-08-31",
        "last_updated": "2016-08-25",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "505-821-3355"
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100002190",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12503348",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimberly Harper Haynes, APRN
• Shanna Hays
• Tracey Hays
• Leslie Ann Hazel, D.M.D.
• HBR Bowling Green, LLC
• Heal & Thrive Therapy
• Healing Path Counseling
• Healing Rivers Therapeutic Massage LLC
• Healthfirst Family Medical Clinic, LLC.
• Ben Nigel Heard, PHARMD

• Alzheimer Center (Dementia Center) in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Alzheimer Center (Dementia Center) in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2016; 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.