Organization
KINDRED NURSING CENTERS WEST, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARILYN A WEAVER (ASSISTANT SECRETARY)
(502) 596-7563
Entity
Organization
Contact information
Practice address
3315 8TH ST, LEWISTON, ID 83501-4966
(208) 743-9543
(208) 743-3945
Mailing address
680 S 4TH ST, LOUISVILLE, KY 40202-2407
(502) 596-7301
(502) 596-4134
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
22
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010013498
REGENCE BLUE SHIELD
ID
01
—
01214
BLUE CROSS OF IDAHO
ID
01
—
337239337239
PREMERA BLUE CROSS
ID
05
—
805218400
—
ID
Enumeration date
07/25/2006
Last updated
10/18/2017
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