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General NPI Number Information
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NPI Number | 1508943283
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Entity Type | Organization
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Legal Business Name | KINDRED NURSING CENTERS WEST, LLC
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 11/29/2017
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Provider Practice Location Address
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Address Line | 660 S CORONADO DR
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City | SIERRA VISTA
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State | AZ
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Zip | 85635-3386
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Country | US
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Telephone | 520-459-4900
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Fax | 520-458-4082
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Provider Business Mailing Address
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Address Line | 680 S 4TH ST # KH-2
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City | LOUISVILLE
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State | KY
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Zip | 40202-2407
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ASSISTANT SECRETARY
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Name | MS. MARILYN A. WEAVER
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Credential |
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Telephone | 502-596-7563
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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 | NCI-338
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License Number State | AZ
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