Provider Demographics
NPI:1295620847
Name:MENIFEE MEADOWS NURSING & REHAB LLC
Entity type:Organization
Organization Name:MENIFEE MEADOWS NURSING & REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BRYON
Authorized Official - Middle Name:D
Authorized Official - Last Name:WOMACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-334-5323
Mailing Address - Street 1:PO BOX 1667
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28603-1667
Mailing Address - Country:US
Mailing Address - Phone:828-324-8898
Mailing Address - Fax:
Practice Address - Street 1:195 BERRYMAN RD
Practice Address - Street 2:
Practice Address - City:FRENCHBURG
Practice Address - State:KY
Practice Address - Zip Code:40322-8496
Practice Address - Country:US
Practice Address - Phone:606-768-9001
Practice Address - Fax:606-768-9005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility