Madisonville Rest Home I LLC

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

Legal business name

MADISONVILLE REST HOME I LLC

Practice address

140 Givens St
Madisonville, KY 42431-1619

Phone

(165) 708-3503

NPI assigned

Jan 30, 2025

Last updated

Jan 30, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Raquel Edery

Title

Coo

Phone

(516) 708-3503

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1738195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738195200000",
    "number": "1609689868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 CENTRAL AVE STE 215",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "115162008",
            "telephone_number": "516-708-3503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 GIVENS ST",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424311619",
            "telephone_number": "165-708-3503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISONVILLE REST HOME I LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-30",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A",
        "authorized_official_last_name": "EDERY",
        "authorized_official_first_name": "RAQUEL",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "516-708-3503"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madisonville Heart Consultants, PSC
• Madisonville MRI LLC
• Madisonville Pediatrics
• Madisonville Pharmacy Inc
• Madisonville Pharmacy Inc
• Magnolia Mind and Wellness PLLC
• Michaela Majors
• Monalisa Faina Maketiwa, RPH
• Jessica Malachowski, MD
• Afzal M Malik, MD

• Assisted Living Facility (Mental Illness) in Madisonville, KY
• Providers in Madisonville, KY by specialty
• Assisted Living Facility (Mental Illness) in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.