Provider Demographics
NPI:1437976750
Name:MASONIC HOMES OF LOUISVILLE LLC
Entity type:Organization
Organization Name:MASONIC HOMES OF LOUISVILLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORP DIRECTOR OF BILLING & REIMB
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:BITAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-753-8331
Mailing Address - Street 1:240 MASONIC HOME DR
Mailing Address - Street 2:
Mailing Address - City:MASONIC HOME
Mailing Address - State:KY
Mailing Address - Zip Code:40041-9000
Mailing Address - Country:US
Mailing Address - Phone:502-897-4907
Mailing Address - Fax:
Practice Address - Street 1:240 MASONIC HOME DR
Practice Address - Street 2:
Practice Address - City:MASONIC HOME
Practice Address - State:KY
Practice Address - Zip Code:40041-9000
Practice Address - Country:US
Practice Address - Phone:502-897-4907
Practice Address - Fax:502-897-8714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility