- Enrollment id
- O20040610000091
- Enrollment state
- KY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1851331672
- Multiple npi flag
- N
- Ccn
- 185133
- Associate id
- 0446233522
- Organization name
- TRADEWATER POINTE, LLC
- Doing business as name
- TRADEWATER HEALTH AND REHABILITATION CENTER
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- TRADEWATER POINTE
- Address line 1
- 100 W RAMSEY ST
- City
- DAWSON SPRINGS
- State
- KY
- Zip code
- 424081739