Provider Demographics
NPI:1215941828
Name:KINDRED NURSING CENTERS LIMITED PARTNERSHIP
Entity type:Organization
Organization Name:KINDRED NURSING CENTERS LIMITED PARTNERSHIP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT SECRETARY
Authorized Official - Prefix:MS
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:A
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-596-7563
Mailing Address - Street 1:680 S. FOURTH ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-2407
Mailing Address - Country:US
Mailing Address - Phone:502-596-6505
Mailing Address - Fax:502-596-4134
Practice Address - Street 1:515 GREENE DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:KY
Practice Address - Zip Code:42345-1409
Practice Address - Country:US
Practice Address - Phone:270-338-5400
Practice Address - Fax:270-338-0507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2017-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY100343314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000054431OtherANTHEM BCBS OF KY
KY33128OtherHEALTH NETWORK CENTRAL
KY1174958OtherCHA PROVIDER NETWORK
KY12503611Medicaid
KY12503611Medicaid