Provider Demographics
NPI:1255434585
Name:KINDRED NURSING CENTERS EAST, L.L.C.
Entity type:Organization
Organization Name:KINDRED NURSING CENTERS EAST, L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, LICENSURE & CERTIFICATION
Authorized Official - Prefix:MS
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-596-7563
Mailing Address - Street 1:680 S 4TH ST # KH-2
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:
Mailing Address - Fax:
Practice Address - Street 1:1 LOVE LN
Practice Address - Street 2:
Practice Address - City:SOUTH DENNIS
Practice Address - State:MA
Practice Address - Zip Code:02660-3445
Practice Address - Country:US
Practice Address - Phone:508-385-6034
Practice Address - Fax:508-385-7064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-05
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0877314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2222532001OtherBLUE CROSS BLUE SHIELD
MA0926451Medicaid
MA4437871OtherAETNA
MA805117OtherTUFTS
MA903325OtherHPHC
MA1034438OtherUNITED HEALTH CARE
MA225320Medicare Oscar/Certification