Healthcare Provider Details

I. General information

NPI: 1255434585
Provider Name (Legal Business Name): KINDRED NURSING CENTERS EAST, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 12/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 LOVE LN
SOUTH DENNIS MA
02660-3445
US

IV. Provider business mailing address

680 S 4TH ST # KH-2
LOUISVILLE KY
40202-2407
US

V. Phone/Fax

Practice location:
  • Phone: 508-385-6034
  • Fax: 508-385-7064
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0877
License Number StateMA

VIII. Authorized Official

Name: MS. MARILYN WEAVER
Title or Position: DIRECTOR, LICENSURE & CERTIFICATION
Credential:
Phone: 502-596-7563