HBR CAMPBELL LANE, LLC (NPI# 1144331216) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144331216 |
| Entity Type | Organization |
| Organization Name | HBR CAMPBELL LANE, LLC |
| Other Organization Name | MAGNOLIA VILLAGE |
| Practice Address |
1381 Campbell Ln Bowling Green KY 42104-1049 |
| Mailing Address |
101 Sun Ave Ne Compliance Department Albuquerque NM 87109-4373 |
| Practice Telephone | 2708430587 |
| Practice Fax Number | 2708430874 |
| Mailing Telephone | 5054685604 |
| Mailing Fax Number | 5054684681 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2016-08-25 |
| Authorized Official Name | MICHAEL T BERG (ASSISTANT SECRETARY) |
| Authorized Official Telephone | 5058213355 |
| Is Organization Subpart | Y |
| Parent Organization Name | HBR KENTUCKY LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311500000X | Alzheimer Center (Dementia Center) | KY | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100002190 | 05 | |
| KY | 12503348 | 05 |
| Other Name | Type Code |
|---|---|
| Magnolia Village | Doing Business As Name - Organization |
| Street Address |
1381 CAMPBELL LN |
| City | BOWLING GREEN |
| State | KY |
| Zip Code | 42104-1049 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235137530 | Wellington Parc Health Systems, Inc. | Skilled Nursing Facility | 1381 Campbell Ln, Bowling Green, KY 42104-1049 | 2005-07-11 |
| 1730667338 | Dadrion Richardson | Physical Therapy Assistant | 1381 Campbell Ln, Bowling Green, KY 42104-1049 | 2018-08-06 |
| 1447765136 | Jayna Nichole Willis | Speech-Language Pathologist | 1381 Campbell Ln, Bowling Green, KY 42104-1049 | 2017-12-04 |
| 1235667783 | Grace Marie Porter | Occupational Therapy Assistant | 1381 Campbell Ln, Bowling Green, KY 42104-1049 | 2017-05-29 |
| 1750749743 | Alexandra Brown | Physical Therapy Assistant | 1381 Campbell Ln, Bowling Green, KY 42104-1049 | 2016-02-04 |
| 1497143283 | Radasha Coleman | Occupational Therapy Assistant | 1381 Campbell Ln, Bowling Green, KY 42104-1049 | 2014-12-31 |
| 1366850620 | Pamela Pollard | Occupational Therapy Assistant | 1381 Campbell Ln, Bowling Green, KY 42104-1049 | 2014-07-30 |
| 1932541141 | Kimberly Frost Hopper | Speech-Language Pathologist | 1381 Campbell Ln, Bowling Green, KY 42104-1049 | 2013-07-29 |
| 1003152745 | Vanessa Gay Carpenter | Occupational Therapy Assistant | 1381 Campbell Ln, Bowling Green, KY 42104-1049 | 2012-12-28 |
| 1619212727 | Debra Lynn Hancock | Physical Therapy Assistant | 1381 Campbell Ln, Bowling Green, KY 42104-1049 | 2012-11-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043822042 | Ashley Marie Sterchi | Speech-Language Pathologist | The Kid Spot Center, 944 Fields Dr. #102, Bowling Green, KY 42104 | 2020-08-20 |
| 1093339111 | Rachel Marie Held | Specialist/Technologist | 886c Lynnwood Way, Apt. #7, Bowling Green, KY 42104 | 2020-06-04 |
| 1043846769 | C D S 10 Pharmacy LLC | Pharmacy | 1308 Ashley Circle, Bowling Green, KY 42104 | 2020-03-13 |
| 1073075792 | Applegate Health Services, Inc | Clinic/Center | 5966 Scottsville Road Unit 7, Bowling Green, KY 42104 | 2019-04-02 |
| 1487122099 | Candice Spencer | Specialist/Technologist, Other | 1945 Scottsville Rd B2 Pmb 397, Bowling Green, KY 42104 | 2018-11-13 |
| 1053819904 | Cumberland Foot and Ankle Centers | Orthopaedic Surgery | 1850 Westen Street, Bowling Green, KY 42104 | 2018-01-25 |
| 1841731494 | Olivia Catherine Sanders | Speech-Language Pathologist | 954 Aristides Dr, Bowling Green, KY 42104 | 2017-03-15 |
| 1376901488 | Trung Trinh | Pharmacist | 1530 Campbell Lane, Bowling Green, KY 42104 | 2016-02-03 |
| 1225409121 | Adam Wesley Baird | Optometrist | 760 Campbell Lane, Suite 120, Bowling Green, KY 42104 | 2015-10-18 |
| 1851797898 | Michelle Leigh King | Speech-Language Pathologist | 829 Mandarin Ave., Bowling Green, KY 42104 | 2014-11-18 |
| Find all providers in zip 42104 | ||||
| Taxonomy Code | 311500000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Alzheimer Center (Dementia Center) |
| A freestanding facility or special care unit of a long term care facility focusing on patient care of individuals diagnosed with dementia or Alzheimer’s Disease or their related diseases. Six elements of the facility/unit set it apart from other (the rest of the) facilities(y): Admission of residents with dementia (including those with Alzheimer's disease); Staff who are specially selected, trained, and supervised; Activities that are specifically designed for the cognitively impaired; A marketing of a special care unit in brochures; A high level of family involvement; and A physical environment designed to keep residents safe and segregated from other populations. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275140816 | Wickshire Blankenbaker Opco, LLC | Alzheimer Center (Dementia Center) | 901 Blankenbaker Pkwy, Louisville, KY 40243-1884 | 2020-09-28 |
| 1104891662 | Wellington Parc Health Systems, Inc. | Alzheimer Center (Dementia Center) | 4747 Alben Barkley Dr, Paducah, KY 42001-6789 | 2006-02-20 |
| 1205336054 | Paducah Center for Health and Rehabilitation, LLC | Alzheimer Center (Dementia Center) | 4747 Alben Barkley Dr, Paducah, KY 42001-6789 | 2018-02-19 |
| 1689109118 | Amazing Adult Day LLC | Alzheimer Center (Dementia Center) | 832 S 6th St, Louisville, KY 40203-2124 | 2017-04-21 |
| 1851402929 | Hbr Barkely Drive LLC | Alzheimer Center (Dementia Center) | 4747 Alben Barkley Dr, Paducah, KY 42001-6789 | 2006-08-31 |
| City | BOWLING GREEN |
| Zip Code | 42104 |
Please comment or provide details below to improve the information on HBR CAMPBELL LANE, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.