REGENCY MANOR LLC NPI 1265509061

Assisted Living Facility in Independence, KY

NPI 1265509061 Organization Assisted Living Facility CLIA Number 18D0953899 CLIA Certificate of Waiver

About REGENCY MANOR LLC

Regency Manor Llc is a provider established in Independence, Kentucky specializing in assisted living facility. The NPI number of Regency Manor Llc is 1265509061 and was assigned on November 2006. The practitioner's primary taxonomy code is 310400000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The authorized official of this NPI record is Mrs. Kelli Lynn Bailey (Administrator)

The CLIA number of Regency Manor Llc is 18D0953899 registered as a "skilled nursing/nursing facility" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Regency Manor Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1265509061

Provider NameREGENCY MANOR LLC
Provider Location Address11725 MADISON PIKE INDEPENDENCE, KY 41051
Provider Mailing Address11725 MADISON PIKE INDEPENDENCE, KY 41051
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date11-29-2006
Last Update Date08-22-2020


Primary Taxonomy

Taxonomy Code310400000X
ClassificationAssisted Living Facility
TypeNursing & Custodial Care Facilities
Taxonomy DescriptionA facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

Business Address

REGENCY MANOR LLC
11725 MADISON PIKE
INDEPENDENCE, KY
ZIP 41051
Phone: (859) 356-9294
Fax: (859) 356-9535

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Mailing Address

REGENCY MANOR LLC
11725 MADISON PIKE
INDEPENDENCE, KY
ZIP 41051
Phone: (859) 356-9294
Fax: (859) 356-9535



Authorized Official

Authorized Official NameMRS. KELLI LYNN BAILEY
Authorized Official TitleADMINISTRATOR
Authorized Official Phone(859) 356-9294

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1265509061 is:

CLIA Number18D0953899
Facility TypeSKILLED NURSING/NURSING FACILITY
Certificate TypeCertificate of Waiver

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.