Healthcare Provider Details

I. General information

NPI: 1447406830
Provider Name (Legal Business Name): KINDRED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2008
Last Update Date: 08/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 HIGH ST
BOWLING GREEN KY
42101-1746
US

IV. Provider business mailing address

4142 BROOKHILL DR
OWENSBORO KY
42303-2185
US

V. Phone/Fax

Practice location:
  • Phone: 270-843-3296
  • Fax:
Mailing address:
  • Phone: 270-685-9454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberAO1373
License Number StateKY

VIII. Authorized Official

Name: LEIGH SMITH
Title or Position: PTA
Credential:
Phone: 270-685-9454