Basic Information
| Provider Information | |||||||||
| NPI: | 1508019514 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BHG WINDSONG LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1313 LYNDON LN | ||||||||
| Address2: | SUITE 201A | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402227351 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5026903061 | ||||||||
| FaxNumber: | 5026903064 | ||||||||
| Practice Location | |||||||||
| Address1: | 120 BROOKMONT RD | ||||||||
| Address2: | |||||||||
| City: | FAIRLAWN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 443333057 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3306667373 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/04/2008 | ||||||||
| LastUpdateDate: | 11/04/2008 | ||||||||
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| AuthorizedOfficialLastName: | TSCHUDI | ||||||||
| AuthorizedOfficialFirstName: | ALLEN | ||||||||
| AuthorizedOfficialMiddleName: | CRAIG | ||||||||
| AuthorizedOfficialTitleorPosition: | MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 5026903061 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | 6194 | OH | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.