Healthcare Provider Details

I. General information

NPI: 1497547590
Provider Name (Legal Business Name): KIMES NURSING & REHAB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 KIMES LN
ATHENS OH
45701-3899
US

IV. Provider business mailing address

2121 LOHMANS CROSSING RD STE 504-879
AUSTIN TX
78734-5217
US

V. Phone/Fax

Practice location:
  • Phone: 740-593-3391
  • Fax:
Mailing address:
  • Phone: 254-224-2616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: LI BORUCKI PRADO
Title or Position: DRCM
Credential:
Phone: 254-224-2616