MEDICARE: KIOWA HILLS REHABILITATION AND NURSING, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1013752898
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIOWA HILLS REHABILITATION AND NURSING, LLC

Provider Business Mailing Address
First Line	:	947 S 500 E STE 105
Second Line	:
City	:	AMERICAN FORK
State	:	UT
Zip	:	84003-3392
Country	:	US
Telephone Number	:	385-492-0194
Fax Number	:

Provider Business Practice Location Address
First Line	:	924 W KIOWA ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80905-1424
Country	:	US
Telephone Number	:	719-636-5221
Fax Number	:

Authorized Official
Title or Position	:	CORPORATE BUSINESS OFFICE DIRECTOR
Name	:	WENDY ANDERSON
Credential	:
Telephone Number	:	385-498-0194

Provider Enumeration Date	:	06/25/2024
Last Update Date	:	01/24/2025

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