- Enrollment id
- O20240925003618
- Enrollment state
- KY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1568290344
- Multiple npi flag
- N
- Ccn
- 185257
- Associate id
- 4284175670
- Organization name
- GREEN RIVER TRAILS, LLC
- Doing business as name
- GREEN RIVER TRAILS
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- GREEN RIVER TRAILS
- Affiliation entity name
- JOURNEY HEALTHCARE
- Affiliation entity id
- 766
- Address line 1
- 213 INDUSTRIAL RD
- City
- GREENSBURG
- State
- KY
- Zip code
- 427431127