SNH Derby Tenant LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SNH DERBY TENANT LLC

Practice address

200 Brookside Dr
Louisville, KY 40243-1200

Phone

(502) 245-3048

Fax

(502) 244-6327

NPI assigned

Sep 10, 2019

Last updated

Oct 11, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

SNH DERBY TENANT LLCAs reported in NPPES

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

Authorized official

Name

Jennifer F. Mintzer

Title

President & Chief Operating Officer

Phone

(617) 796-8350

Specialties & licenses 2

Addresses

Other names 1

• The Forum at Brookside Other name

Part of

SNH Derby Tenant LLC

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

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633910400000",
    "number": "1275182453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 WASHINGTON ST STE 300",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024581634",
            "telephone_number": "617-796-8350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BROOKSIDE DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402431200",
            "telephone_number": "502-245-3048",
            "fax_number": "502-244-6327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNH DERBY TENANT LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SNH DERBY TENANT LLC",
        "enumeration_date": "2019-09-10",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A",
        "authorized_official_last_name": "MINTZER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "617-796-8350"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Forum at Brookside",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "The Forum at Brookside",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Amanda L Sneed, LCSW
• Taja Sneed, B.S.
• Karen Angela Snell-Garus, M.D.
• Kevin Jay Snellen, LPCC
• Victoria Snelling, D.C.
• Bethany Cox Snider, M.D.
• Henry Snider
• Joseph Matthew Snider, MD
• Kevin M Snipes, O.D.
• Elizabeth Snodgrass

• Assisted Living Facility in Louisville, KY
• Providers in Louisville, KY by specialty
• Assisted Living Facility in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2021; 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.