Organization
KIMWELL SNF OPCO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS DESTEFANE (PRESIDENT)
(314) 543-3800
Entity
Organization
Contact information
Practice address
495 NEW BOSTON RD, FALL RIVER, MA 02720-5835
(508) 679-0106
Mailing address
1869 CRAIG PARK CT, SAINT LOUIS, MO 63146-4122
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
04/17/2026
Last updated
04/17/2026
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