Healthcare Provider Details

I. General information

NPI: 1447333141
Provider Name (Legal Business Name): KINDRED NURSING CENTERS EAST, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 09/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W CONSTANCE RD
SUFFOLK VA
23434-4413
US

IV. Provider business mailing address

680 S. 4TH STREET
LOUISVILLE KY
40202-2407
US

V. Phone/Fax

Practice location:
  • Phone: 757-539-8744
  • Fax: 757-539-6128
Mailing address:
  • Phone: 502-596-7301
  • Fax: 502-596-4134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH2636
License Number StateVA

VIII. Authorized Official

Name: MS. MARILYN A. WEAVER
Title or Position: ASSISTANT SECRETARY
Credential:
Phone: 502-596-7300