- Enrollment id
- O20251007002357
- Enrollment state
- KY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1154130540
- Multiple npi flag
- N
- Ccn
- 185468
- Associate id
- 2365949369
- Organization name
- CHESTNUT SNF OPERATIONS LLC
- Doing business as name
- CHESTNUT RIDGE HEALTH & REHABILITATION
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- CHESTNUT RIDGE HEALTH & REHABILITATION
- Affiliation entity name
- LYON HEALTHCARE
- Affiliation entity id
- 837
- Address line 1
- 1015 MAGAZINE ST
- City
- LOUISVILLE
- State
- KY
- Zip code
- 402032017