Provider Demographics
NPI:1174167514
Name:STANFORD CARE AND REHAB, LLC
Entity type:Organization
Organization Name:STANFORD CARE AND REHAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AR BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-255-0075
Mailing Address - Street 1:1050 CHINOE RD STE 350
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-6571
Mailing Address - Country:US
Mailing Address - Phone:859-255-0075
Mailing Address - Fax:859-281-5150
Practice Address - Street 1:105 HARMON HTS
Practice Address - Street 2:
Practice Address - City:STANFORD
Practice Address - State:KY
Practice Address - Zip Code:40484-1111
Practice Address - Country:US
Practice Address - Phone:606-365-2141
Practice Address - Fax:606-393-0890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-29
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility