Extendicare Homes, Inc.

Organization Active NPI Skilled Nursing Facility · Springfield, KY

NPI 1376617837 · NPPES record last updated Apr 1, 2008

Key facts

NPI
1376617837
Entity type
Organization (NPI type 2)
Primary specialty
Skilled Nursing Facility 314000000X
Legal business name
EXTENDICARE HOMES, INC.
Practice address
420 E Grundy Ave
Springfield, KY 40069-1173
Phone
(859) 336-7771
Fax
(859) 336-9571
NPI assigned
Nov 17, 2006
Organization subpart
No

Authorized official

Name
Donna Jo Maassen
Title
Director of Compliance
Phone
(414) 908-8119

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Yes

Addresses

Primary practice location

420 E Grundy Ave
Springfield, KY 40069-1173

Mailing address

111 W Michigan St
Milwaukee, WI 53203-2903
Phone (414) 908-8119

Other identifiers

IdentifierTypeStateIssuer
12500872MedicaidKY

Other names

  • Springfield Nursing and Rehab Center Doing business as

Other providers in Springfield, KY

All providers in Springfield, KY · Skilled Nursing Facility in Kentucky

Sources for this page

Verify at the official NPI Registry.