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General NPI Number Information
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NPI Number | 1215910211
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Entity Type | Organization
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Legal Business Name | KINDER RETIREMENT AND REHABILITATION CENTER, LLC
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Dates
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Enumeration Date | 11/22/2005
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Last Update Date | 01/07/2019
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Provider Practice Location Address
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Address Line | 13938 HWY 165
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City | KINDER
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State | LA
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Zip | 70648
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Country | US
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Telephone | 337-738-5671
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Fax | 337-738-5777
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Provider Business Mailing Address
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Address Line | PO BOX 1270
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City | KINDER
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State | LA
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Zip | 70648-1270
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Country | US
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Telephone | 337-738-5671
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Fax | 337-738-5777
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. JACK SANDERS
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Credential |
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Telephone | 318-590-0007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 360
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License Number State | LA
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