# KENEDY MANOR NURSING HOME INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Legacy Living Centers
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124015268
- **Authorized official:** JANICE PITA (INSURANCE/MEDICARE)
- **Authorized official phone:** (580) 622-6300

## Contact information

- **Practice address:** 7882 S HIGHWAY 181, DRAWER E, KENEDY, TX 78119
- **Practice address phone:** (830) 583-9101
- **Practice address fax:** (830) 583-2962
- **Mailing address:** 7882 S HIGHWAY 181, DRAWER E, KENEDY, TX 78119-0930
- **Mailing address phone:** (830) 583-9101
- **Mailing address fax:** (830) 583-2962

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 115272 | TX | Yes |

## Other

- **Enumeration date:** 10/04/2005
- **Last updated:** 11/07/2007