Diversicare Leasing Corp.

NPI #1093703308 in Grayson, Kentucky

Provider Information

NPI Number
1093703308
Entity Type
Organization
Organization Name
Diversicare Leasing Corp.
Primary Specialty
Skilled Nursing Facility
Enumeration Date
Oct 11, 2005
Last Updated
Aug 22, 2020

Practice Location

Address
250 MCDAVID BLVD
ZIP Code
41143-1603
Phone
(606) 474-7835

Authorized Official

Name
RAYMOND L. TYLER JR.
Title
EXECUTIVE VICE PRESIDENT AND COO
Phone
(615) 771-7575

Specialties & Taxonomy Codes

Specialty
Skilled Nursing Facility

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