# KINDRED- HACIENDA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427322403
- **Authorized official:** MARILYN WEAVER (ASSISTANT SECRETARY)
- **Authorized official phone:** (502) 596-7563

## Contact information

- **Practice address:** 660 S CORONADO DR, SIERRA VISTA, AZ 85635-3386
- **Practice address phone:** (520) 459-4900
- **Mailing address:** 680 S 4TH ST \# KH-2, LOUISVILLE, KY 40202-2407

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | SLP0587 | AZ | Yes |

## Other

- **Enumeration date:** 03/08/2012
- **Last updated:** 11/30/2017